Characteristics and prognosis of jejunoileal gastrointestinal stromal tumours (GISTs) in the era of imatinib: a comparative study with gastric GISTs

• J. A. Fernández ^[1] ; D. Ferreras ^[1] ; J. J. Ruiz-Manzanera ^[2] ; V. Olivares ^[1] ; B. Ferri ^[1] ; M. D. Frutos ^[1] ; J. Martínez ^[2]
  1. [1] Hospital Virgen de la Arrixaca

     Hospital Virgen de la Arrixaca

     Murcia, España

     
  2. [2] Hospital Universitario Virgen de la Arrixaca
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 23, Nº. 7 (July), 2021, págs. 1368-1376
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Background Gastrointestinal stromal tumours (GISTs) located in the jejunum or ileum (JI-GIST) are considered worse prognosis compared to those of gastric (G-GIST) location. It has been suggested that this dogma should be revised. The aim of this study was to describe the characteristics of jejunoileal GISTs and its prognosis and to compare them with G-GISTs in the era of imatinib.

    Methods We retrospectively reviewed the clinical histories of all the patients diagnosed with GISTs between January 2000 and November 2016: Clinical and pathological data, as recurrence, metastatic state, disease-free survival (DFS) as well as overall survival (OS) rates of patients were reviewed.

    Results JI-GIST patients comprise 29 cases (37.7%). Compared to G-GIST, JI-GIST patients had undergone emergency surgery more frequently (37.9% vs. 10.4%, p = 0.007). According to the NIH-Fletcher classification, the low or very-low risk group represents 17.2% of JI-GISTs as opposed to 37.6% of G-GISTs (p < 0.005). When the AFIP-Miettinen system was used the low or very-low group represented 17.2% of JI-GISTs vs. 58.4% in the G-GISTs group (p < 0.001). Both local recurrence (24.1% vs. 12.5%, p < 0.05) and metastatic rate (34.5% vs. 22.9%, p < 0.05) were higher in the JI-GIST group than in G-GIST. 5- and 10-year DFS and 10-year OS rate were lower for JI-GIST (54.5% and 39.6% vs. 77.2% and 60.8%, and 57.9% vs. 65%, respectively, p < 0.05).

    Conclusions The observed differences between both groups in DFS and OS rates at long term could be attributed to the effect of imatinib.