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Association Between Gastrointestinal Stromal Tumors and Other Malignancies: It Is Only a Matter of Time ? A Case Series and an Overview of Systematic Reviews

  • Mauro PoddaEmail author
  • Giulia Ferraro
  • Salomone Di Saverio
  • Alessandro Cois
  • Oreste Nardello
  • Gaetano Poillucci
  • Marco Vito Marino
  • Adolfo Pisanu
Original Research

Abstract

Purpose

Little is known about the sporadic coincidence of gastrointestinal stromal tumors (GISTs) with second primary tumors (SPTs). The aim of this study is to clarify if there is a clinicopathologic correlation responsible for the synchronous or metachronous occurrence of SPTs in GIST patients.

Methods

We carried out a single-center, retrospective analysis on patients with GISTs surgically treated at our institution from January 2019 to June 2019. Two groups of patients were identified: isolated GIST (group A) and GIST associated with SPT (group B). A meta-review was conducted with the aim to examine the published systematic reviews that included studies assessing the SPT risk in GIST patients.

Results

Thirty-nine patients were surgically treated for GIST during the study period, with seven (17.9%) of them having other SPTs. SPTs were most frequent in the colon. Group A patients had a lower mean age at initial diagnosis (56.8 ± 15.2 vs. 73.4 ± 16.6, P = 0.012). No statistically significant difference was found between the two groups in terms of tumor location, mitotic index, Ki-67 expression, risk classification, and imatinib therapy. The overview showed that the cumulative prevalence rate of SPTs ranged from 9.3 to 18.0%. SPTs were more frequent in the gastrointestinal tract (37.9–95.0%), followed by the genitourinary tract.

Conclusion

GIST patients under our care experienced a 17.9% overall risk of developing SPTs with different histology. When comparing patients with isolated GIST and patients with GIST and SPT, age was the only variable significantly related to the development of other neoplasms. However, the potential non-random association and causal relationship between GISTs and SPTs remain to be investigated.

Keywords

Gastrointestinal stromal tumors Associated neoplasms Synchronous malignancies Secondary primary tumors Overview of systematic reviews 

Notes

Author Contribution

Mauro Podda: Study conception and design, literature search, acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Giulia Ferraro: Study conception and design, literature search, acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Salomone Di Saverio: Interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Alessandro Cois: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Oreste Nardello: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Gaetano Poillucci: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Marco Vito Marino: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Adolfo Pisanu: Study conception and design, literature search, interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published.

Funding information

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors

Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was conducted after the approval of the Institutional Ethics Review Board of the Azienda Ospedaliero-Universitaria di Cagliari, Cagliari University Hospital “D. Casula,” Cagliari, Italy.

Informed Consent

An informed consent for enabling the sharing of research data was obtained from all individual patients included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryCagliari University Hospital “D. Casula”, University of CagliariCagliariItaly
  2. 2.Department of Surgery, Cambridge Colorectal Unit, Addenbrooke’s Hospital NHS Foundation TrustUniversity of CambridgeCambridgeUK
  3. 3.Department of Surgery “Paride Stefanini”Policlinico Universitario Umberto I, Sapienza UniversityRomeItaly
  4. 4.Department of General SurgeryHospital Universitario Marques de ValdecillaSantanderSpain

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