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Surgery for Gastrointestinal Stromal Tumors (GISTs) of the Stomach and Small Bowel: Short- and Long-Term Outcomes Over Three Decades

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Abstract

Background

Many studies on gastrointestinal stromal tumors (GISTs) derive from tertiary referral centers, but few examine strictly population-based cohorts. Thus, we evaluated the clinical features, surgical treatments, clinical outcomes, and factors predicting the survival of patients with GISTs in a population-based series.

Methods

Patients with GISTs diagnosed at Stavanger University Hospital over three decades (1980–2012) were analyzed. Data were retrieved from hospital records. Descriptive statistics and survival analyses (Kaplan–Meier) are presented. A limited number of colorectal GISTs (n = 6) restricted most analyses to those with a gastric or small bowel location.

Results

Among 66 patients surgically treated for GISTs, 60 patients (91 %) had either a gastric or a small bowel localization. Females comprised 61 %. The median age at diagnosis was 63 (range, 15–88) years. Clinical symptoms were recorded in 43 patients (65 %). Complete tumor resection was achieved in 85 % of the patients. During follow-up, 6 patients were surgically treated for local recurrence or metastatic disease. The median follow-up time was 6.1 years. At last follow-up, 30 patients (46 %) were deceased, 10 of whom died from GISTs. The median overall survival was 10.4 years. For GISTs with a gastric or small bowel location, a 1- and 5-year disease-specific survival of 100 and 96 %, and a relapse-free survival of 96 and 78 % were observed. Male gender, incidental diagnosis, smaller tumor size, a low mitotic rate, an intact pseudocapsule, low-risk categorization, and an early stage were significantly associated with improved outcomes.

Conclusion

Surgery in a low-volume, population-based setting yields enhanced long-term disease and recurrence-free survival for patients with GISTs of the stomach or small bowel. Incidental diagnosis, complete tumor resection, and low-risk categorization are good predictors of long-term prognosis.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Stavanger University Hospital, 4068, Stavanger, Norway

    Oddvar M. Sandvik, Kjetil Søreide & Jon Arne Søreide

  2. Department of Pathology, Stavanger University Hospital, Stavanger, Norway

    Einar Gudlaugsson

  3. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Oddvar M. Sandvik, Kjetil Søreide & Jon Arne Søreide

Authors
  1. Oddvar M. Sandvik
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  2. Kjetil Søreide
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  3. Einar Gudlaugsson
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  4. Jon Arne Søreide
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Correspondence to Jon Arne Søreide.

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Sandvik, O.M., Søreide, K., Gudlaugsson, E. et al. Surgery for Gastrointestinal Stromal Tumors (GISTs) of the Stomach and Small Bowel: Short- and Long-Term Outcomes Over Three Decades. World J Surg 39, 446–452 (2015). https://doi.org/10.1007/s00268-014-2824-4

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  • DOI: https://doi.org/10.1007/s00268-014-2824-4

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