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Observational Study
. 2022 Jun 17:35:e1658.
doi: 10.1590/0102-672020210002e1658. eCollection 2022.

GASTROINTESTINAL STROMAL TUMOR: OUTCOMES OF THE PAST DECADE IN A REFERENCE INSTITUTION IN SOUTHERN BRAZIL

Eduardo Morais Everling  1 , Daniele Marchet  1 , Natália Marchet DE-Antoni  1 , Bruna Bley Mattar Isbert  1   2 , Gustavo Vasconcelos Alves  3   4 , Tomaz de Jesus Maria Grezzana-Filho  1   2
Affiliations
Observational Study

GASTROINTESTINAL STROMAL TUMOR: OUTCOMES OF THE PAST DECADE IN A REFERENCE INSTITUTION IN SOUTHERN BRAZIL

Eduardo Morais Everling et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Aim: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the digestive tract and has a wide variation in biological behavior; surgical resection remains the main form of treatment. This study aimed to analyze clinicopathological characteristics and survival of patients with GIST in a reference institution for oncological diseases.

Methods: An observational, longitudinal, and retrospective study of patients diagnosed with GIST from January 2011 to January 2020 was carried out by analyzing epidemiological and clinical variables, staging, surgical resection, recurrence, use of imatinib, and curves of overall survival (OS) and disease-free survival (DFS).

Results: A total of 38 patients were included. The majority (58%) of patients were males and the median age was 62 years. The primary organs that were affected by this tumor were stomach (63%) and small intestine (17%). Notably, 24% of patients had metastatic disease at diagnosis; 76% of patients received surgical treatment and 13% received neoadjuvant treatment; and 47% of patients received imatinib as adjuvant or palliative therapy. Tumor recurrence was 13%, being more common in the liver. The 5-year OS was 72.5% and DFS was 47.1%. The operated ones had better OS (87.1% vs. 18.5%) and DFS (57.1% vs. 14.3%) in 5 years. Tumor size ≥5 cm had no difference in OS at 5 years, but DFS was 24.6%, when compared with 92.3% of smaller tumors. Patients who were undergoing neoadjuvant therapy and/or using imatinib did not show any significant differences.

Conclusions: Surgical treatment with adequate margins allows the best gain in survival, and the use of imatinib in more advanced cases has prognostic equity with less advanced-stage tumors. Treatment of metastatic tumors seems promising, requiring further studies.

O Tumor estromal gastrointestinal (Gastrointestinal stromal tumor - GIST) é a neoplasia mesenquimal mais comum do trato digestivo, possui comportamento biológico variado e a principal forma de tratamento é a ressecção cirúrgica.

OBJETIVO:: analisar as características clínico-patológicas e a sobrevida de pacientes com GIST em uma instituição de referência para doenças oncológicas.

MÉTODOS:: Foi realizado um estudo observacional, longitudinal e retrospectivo de pacientes com diagnóstico de GIST de janeiro de 2011 a janeiro de 2020, analisando variáveis epidemiológicas e clínicas, estadiamento, ressecção cirúrgica, recidiva, uso de imatinibe e curvas de sobrevida global (SG) e sobrevida livre de doença (SLD).

RESULTADOS:: foram incluídos 38 pacientes, a maioria (58%) do sexo masculino, idade mediana de 62 anos. Os principais órgãos primários foram estômago (63%) e intestino delgado (17%). 24% tinham doença metastática ao diagnóstico. 76% receberam tratamento cirúrgico e 13% tratamento neoadjuvante. 47% dos pacientes receberam Imatinib como terapia adjuvante ou paliativa. A recorrência tumoral foi de 13%, mais comum no fígado. SG de 5 anos foi de 72,5% e SLD 47,1%. Os operados tiveram melhor SG (87,1% vs. 18,5%) e SLD (57,1% vs. 14,3%) em 5 anos. O tamanho do tumor igual ou maior que 5 cm não teve diferença na SG em 5 anos, mas SLD foi de 24,6%, em comparação com 92,3% dos tumores menores. Pacientes em terapia neoadjuvante e/ou em uso de imatinibe não apresentaram diferenças significativas.

CONCLUSÕES:: O tratamento cirúrgico com margens adequadas permite o melhor ganho de sobrevida, e o uso de Imatinibe em casos mais avançados tem equidade prognóstica com tumores em estágio menos avançado. O tratamento de tumores metastáticos parece promissor, necessitando de mais estudos.

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Conflict of interest statement

Conflict of interests: No

Figures

Figure 1 -
Figure 1 -. Overall survival (A) and disease-free survival (B) in 5 years of patients diagnosed with gastrointestinal stromal tumors.
Figure 2 -
Figure 2 -. Kaplan-Meier charts related to surgical treatment for patients with GIST. (A) Overall survival in 5 years - with or without surgery; (B) disease-free survival in 5 years - with or without surgery; (C) Overall survival in 5 years - according to the type of resection; (D) Disease-free survival in 5 years - according to the type of resection.
Figure 3 -
Figure 3 -. Kaplan-Meier chart relating overall survival in 5 years to the Fletcher’s classification.
Figure 4 -
Figure 4 -. Kaplan-Meier charts relating overall and disease-free survival in 5 years to tumor size.
See this image and copyright information in PMC

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References

    1. Alberto S, Sánchez P, Oliveira M, Cuesta L, Gomes F, Figueiredo A, Pinheiro N, Ramos de Deus J. Gastrointestinal stromal tumors - a retrospective study of 43 cases. Rev Esp Enferm Dig. 2008;100(11):696–700. - PubMed
    1. Bannon AE, Klug LR, Corless CL, Heinrich MC. Using molecular diagnostic testing to personalize the treatment of patients with gastrointestinal stromal tumors. Expert Rev Mol Diagnost. 2017;17(5):445–457. doi: 10.1080/14737159.2017.1308826. - DOI - PubMed
    1. Cavnar MJ, Seier K, Curtin C, Balachandran VP, Coit DG, Yoon SS, Crago AM, Strong VE, Tap WD, Gonen M, et al. Outcome of 1000 patients with gastrointestinal stromal tumor (GIST) treated by surgery in the pre-and post-imatinib eras. 1Ann Surg. 2021;273:128–138. doi: 10.1097/sla.0000000000003277. - DOI - PMC - PubMed
    1. De Oliveira LRP, Pace FHL, De Souza AFM. HU Revista. 2. Vol. 37. Juiz de Fora: 2011. Gastrointestinal stromal tumors: review of literature; pp. 247–255.https://periodicos.ufjf.br/index.php/hurevista/article/view/1306
    1. De Oliveira RP, Portari PE, Filho, Iglesias AC, de Oliveira CA, Pannain VL. Comparative study of the different degrees of risk of gastrointestinal stromal tumor. Rev Col Bras Cir. 2015;42(1):32–36. doi: 10.1590/0100-69912015001007. - DOI - PubMed

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