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Characteristics and prognosis of rectal gastrointestinal stromal tumors: an analysis of registry data

Surgery Today volume 47, pages 1188–1194 (2017)Cite this article

Abstract

Purpose

Rectal gastrointestinal stromal tumors (GISTs) are rare. Accordingly, their clinical features are not well-documented and optimal treatment has not been established. The objective of this study is to clarify the rates and patterns of recurrence after surgical resection of rectal GISTs, with a focus on outcomes and therapeutic modalities.

Methods

The registry was designed to collect data on rectal GISTs recorded between January, 2003 and December, 2007 at 40 participating institutions of the Kinki GIST Study Group. The principal variables were the rates and patterns of recurrence of rectal GISTs. Other study variables were age, sex, tumor size, mitotic count, distance from the anal verge, tumor location, surgical procedures, surgical margins, and recurrence-free survival.

Results

Twenty-four cases were registered, 11 (45.8%) of which were classified as high-risk by the modified NIH criteria. Locoregional recurrence (7/23, 30.4%) was the predominant recurrence pattern after curative resection, with rates that did not differ after local excision (33.3%; 3/9) vs. extended resection (28.6%; 4/14). The recurrence rates were high (25.0%) even for patients with low-risk disease. There was only one case of recurrence among patients who received perioperative treatment with imatinib.

Conclusions

Rectal GISTs showed high rates of local recurrence regardless of the surgical procedure. Perioperative treatment with imatinib may improve outcomes.

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Acknowledgements

We thank all of the participating patients and investigators. This study was performed by the Kinki GIST Study Group. Participating institutions (listed according to the number of patients included) are as follows: Osaka University Hospital, Osaka Red Cross Hospital, Osaka General Medical Center, Toyonaka Municipal Hospital, Higashiosaka City General Hospital, Shizuoka General Hospital, National Hospital Organization Osaka National Hospital, Osaka Police Hospital, Sakai Municipal Hospital, Kanazawa Medical University Hospital, Kitano Hospital, Juntendo University Shizuoka Hospital, Osaka Rosai Hospital, Osaka Medical College Hospital, Kinki University Hospital, National Hospital Organization Osaka Minami Medical Center, Osaka General Medical Center, and Kansai Medical University Takii Hospital.

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Affiliations

  1. Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Nakamichi 1-3-3, Higashinari-ku, Osaka, Osaka, 537-8511, Japan

    Masayoshi Yasui

  2. Department of Surgery, Kaizuka City Hospital, Hori 3-10-20, Kaizuka, Osaka, 597-0015, Japan

    Toshimasa Tsujinaka

  3. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Yamadaoka 2-2(E2), Suita, Osaka, 565-0871, Japan

    Masaki Mori & Tsuyoshi Takahashi

  4. Department of Surgery, Osaka Red Cross Hospital, Fudegasaki-cho 5-30, Tennoji-ku, Osaka, Osaka, 543-8555, Japan

    Yasuo Nakashima

  5. National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-Ku, Tokyo, 104-0045, Japan

    Toshirou Nishida

Authors
  1. Masayoshi Yasui
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  2. Toshimasa Tsujinaka
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  3. Masaki Mori
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  4. Tsuyoshi Takahashi
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  5. Yasuo Nakashima
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  6. Toshirou Nishida
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on behalf of the Kinki GIST Study Group

Corresponding author

Correspondence to Masayoshi Yasui.

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Conflicts of interest

Toshimasa Tsujinaka had a consultancy in Taiho Pharmaceutical Co. and Yakult Co., was on the speaker’s bureau for Taiho Pharma. Co., Otsuka Co., Abott Co. and Johnson & Johnson and received honoraria for manuscript preparation from MSD.; Tsuyoshi Takahashi received honoraria from Novaritis, Pfizer and Bayer for a lecture and received research funding from SBI Pharma. The remaining authors declare no conflicts of interest.

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Yasui, M., Tsujinaka, T., Mori, M. et al. Characteristics and prognosis of rectal gastrointestinal stromal tumors: an analysis of registry data. Surg Today 47, 1188–1194 (2017). https://doi.org/10.1007/s00595-017-1524-8

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  • DOI: https://doi.org/10.1007/s00595-017-1524-8

Keywords

  • Rectum
  • Gastrointestinal stromal tumors
  • Recurrence