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Gastrointestinal Stromal Tumours (GIST): A Review of Cases from Nigeria

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Abstract

Purpose

Gastrointestinal stromal tumours (GIST) are rare and studies on GIST in Nigeria are extremely uncommon. This study aims to achieve a comprehensive systematic review of the cases of this tumour in Nigerians.

Methods

A systematic search of all available literature on GIST published from Nigeria between January 2000 and December 2018 was done and reviewed. Simple descriptive data on all the cases are presented.

Results

The search yielded 15 publications but 13 publications with a total of 67 patients were analysed. The other two studies centred on imatinib therapy and overall survival, and molecular characteristics respectively and were therefore reviewed independently. Age at diagnosis ranged from 9 to 75 years, with mean age being in the 50s and 60s across most studies. There is no gender disparity. Anatomical location of primary tumours showed gastric location as the most frequent (61%) followed by large intestine accounting for 15%, the small intestine (9%) and other locations (15%). Tumour size ranged from 5–39.5 cm. Over 85% of patients had tumour size greater than 10 cm at presentation, hence fell into intermediate or high-risk group irrespective of location of tumour. The overall survival of a cohort of 27 patients that had imatinib therapy was 69.5% after 4 years of follow-up. KIT exon 11 mutations were the only mutations detected from a small cohort of 12 patients.

Conclusions

Characteristics of GIST in Nigerians are fairly similar to other parts of the world. However, most of our patients present with large masses which are of poor prognostic characteristics.

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References

  1. Miettinen M, Majidi M, Lasota J. Pathology and diagnostic criteria of gastrointestinal stromal tumors (GISTs): a review. Eur J Cancer. 2002;38(Suppl 5):S39–51.

    PubMed  Google Scholar 

  2. Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour. Lancet. 2007;369(9574):1731–41.

    CAS  PubMed  Google Scholar 

  3. Weiss S. Enzinger and Weiss’s soft tissue tumours. 5th ed. 1268 p.

  4. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279(5350):577–80.

    CAS  PubMed  Google Scholar 

  5. Sanders KM, Koh SD, Ward SM. Interstitial cells of cajal as pacemakers in the gastrointestinal tract. Annu Rev Physiol. 2006;68:307–43.

    CAS  PubMed  Google Scholar 

  6. Min KW, Leabu M. Interstitial cells of Cajal (ICC) and gastrointestinal stromal tumor (GIST): facts, speculations, and myths. J Cell Mol Med. 2006;10(4):995–1013.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Wang X, Mori I, Tang W, Utsunomiya H, Nakamura M, Nakamura Y, et al. Gastrointestinal stromal tumors: are they of cajal cell origin? Exp Mol Pathol. 2002;72(2):172–7.

    CAS  PubMed  Google Scholar 

  8. Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23(2):70–83.

    PubMed  Google Scholar 

  9. Lassarat S, Jootar S. Ongoing challenges of a global international patient assistance program. Ann Oncol Off J Eur Soc Med Oncol. 2006;17(Suppl 8):viii43–6.

    Google Scholar 

  10. Durosinmi MA, Salawu L, Lawal OO, Ojo OS, Alatishe OI, Oyekunle AA, et al. Imatinib (Glivec) and gastrointestinal stromal tumours in Nigerians. Afr J Med Med Sci. 2013;42(4):325–32.

    CAS  PubMed  Google Scholar 

  11. van Oosterom AT, Judson I, Verweij J, Stroobants S, Donato di Paola E, Dimitrijevic S, et al. Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet. 2001;358(9291):1421–3.

    PubMed  Google Scholar 

  12. Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med. 2001;344(14):1052–6.

    CAS  PubMed  Google Scholar 

  13. Parab TM, DeRogatis MJ, Boaz AM, Grasso SA, Issack PS, Duarte DA, et al. Gastrointestinal stromal tumors: a comprehensive review. J Gastrointest Oncol. 2019;10(1):144–54.

    PubMed  PubMed Central  Google Scholar 

  14. Patel N, Benipal B. Incidence of gastrointestinal stromal tumors in the United States from 2001-2015: a United States cancer statistics analysis of 50 states. Cureus. 2019;11(2):e4120.

    PubMed  PubMed Central  Google Scholar 

  15. Abdulkareem FB, Rotimi O, Elesha SO, Banjo AA. Immunophenotyping of gastrointestinal mesenchymal tumours in Lagos, Nigeria. West Afr J Med. 2009;28(6):358–62.

    CAS  PubMed  Google Scholar 

  16. Ogun GO. Mesenchymal tumours of the gastrointestinal tract: the importance and use of immunohistochemistry in characterizing specific tumour entities. Niger J Med. 2015;24(2):150–4.

    PubMed  Google Scholar 

  17. Mohammed DM, Ahmed A, Yahaya UA, Lawal K, Almustapha LA, Shehu SM. Gastrointestinal stromal tumor of the stomach: evaluation and treatment in a poor-resource setting. Arch Int Surg. 2012;2(1):11.

    Google Scholar 

  18. Ezeome ER, Olusina DB, Igbokwe UO. Gastrointestinal stromal tumours at the University of Nigeria Teaching Hospital Enugu, Nigeria: an immunohistochemical study of GIT mesenchymal tumours. Niger J Clin Pract. 2010;13(3):306–10.

    CAS  PubMed  Google Scholar 

  19. Oludara MA, Onyekwere C, Ibrahim NA, Popoola A, Omodele FO. Gastrointestinal stromal tumours: a review of cases seen at a university hospital over an eight year period. Niger J Gastroenterol Hepatol. 2013;5(1):35 -40–40.

    Google Scholar 

  20. Samuel DO, Philip I, Omotara SM. Gastrointestinal stromal tumour in a young adult. J Coll Physicians Surg--Pak. 2010;20(9):618–9.

    PubMed  Google Scholar 

  21. Afuwape OO, Irabor DO, Ladipo JK. Gastrointestinal stromal tumour in Ibadan, Nigeria: a case report and review of current treatment. Afr Health Sci. 2011;11(1):134–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Oluyemi A, Oyekan O. Massive upper gastrointestinal bleeding from a gastrointestinal stromal tumor: case report and short literature review. Niger J Gastroenterol Hepatol. 2011;3(1&2):39–41.

    Google Scholar 

  23. Ahmed S, Abubakar M, Mohammed U, Mayun A. Gastrointestinal stromal tumor of the appendix. Onc Gas Hep Rep. 2014;3:38–40.

    Google Scholar 

  24. Oluyemi A, Keshinro S, Jimoh A, Oshun P. Gastrointestinal stromal tumor of the anal wall in a Nigerian. Pan Afr Med J. 2015;22:161.

    PubMed  PubMed Central  Google Scholar 

  25. Akere A, Oguntola A, Ojemakinde K. Gastrointestinal stromal tumuor- case report and a review of the literature. Ann Ib Postgrad Med. 2008;6(2):63–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Ahmadu BU, Nnanubumom AA, Ibrahim RA. Rare occurrence of mix stromal tumours: a case report of gastrointestinal and extra-intestinal stromal tumour on the jejunum and omentum of a nine year old girl from Adamawa State. Nigeria Ethiop J Health Sci. 2013;23(2):174–7.

    PubMed  Google Scholar 

  27. Omorogbe O, Iloh A, Egigba O, Osime O. Stromal tumour of the ileum: an unusual cause of massive gastrointestinal bleeding. P H Med J. 2017;11(1):45.

    Google Scholar 

  28. Ogun GO, Lasota J, Oluwasola O, Miettinen M, Ogunbiyi J, Akang E. Gastrointestinal stromal tumors (GIST) in Ibadan: immunohistochemical and molecular genetic study. In: Proceedings of the 16th Biennial International Conference of the West African Society of Gastroenterology, (WASOG). Jos,Nigeria: West African Society of Gastroenterology, (WASOG); 2006. p. Abstract No 2.2 p 21.

  29. Fletcher CDM, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol. 2002;33(5):459–65.

    PubMed  Google Scholar 

  30. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39(10):1411–9.

    PubMed  Google Scholar 

  31. Edge S, Byrd DR, Compton CC, Fritz AG, Greene F, Trotti A, editors. AJCC cancer staging handbook: from the AJCC cancer staging manual [Internet]. 7th ed. New York: Springer-Verlag; 2010. [cited 2019 May 12]. Available from: https://www.springer.com/us/book/9780387884424

    Google Scholar 

  32. Søreide K, Sandvik OM, Søreide JA, Giljaca V, Jureckova A, Bulusu VR. Global epidemiology of gastrointestinal stromal tumours (GIST): a systematic review of population-based cohort studies. Cancer Epidemiol. 2016;40:39–46.

    PubMed  Google Scholar 

  33. Hartley RJ, Becker JHR, Van der Walt H, Luvhengo T. Gastro-intestinal stromal tumours (GISTs) - the Pretoria experience and a literature review. South Afr J Surg. 2011;49(3):128–31.

    CAS  Google Scholar 

  34. al Haddad BJS, Jedy-Agba E, Oga E, Ezeome ER, Obiorah CC, Okobia M, et al. Comparability, diagnostic validity and completeness of Nigerian cancer registries. Cancer Epidemiol. 2015;39(3):456–64.

    Google Scholar 

  35. Jedy-Agba E, Curado MP, Ogunbiyi O, Oga E, Fabowale T, Igbinoba F, et al. Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer Epidemiol. 2012;36(5):e271–8.

    PubMed  PubMed Central  Google Scholar 

  36. Abdulkareem FB, Odubanjo OM, Awolola AN. Pathological services in Sub-Saharan Africa, a barrier to effective cancer care. In: Adedeji OA, editor. Cancer in Sub-Saharan Africa: Current Practice and Future [Internet]. Cham: Springer International Publishing; 2017. p. 53–64 [cited 2019 Apr 11]. Available from:. https://doi.org/10.1007/978-3-319-52554-9_4.

    Chapter  Google Scholar 

  37. Al-Kalaawy M, El-Zohairy MA, Mostafa A, Al-Kalaawy A, El-Sebae H. Gastrointestinal stromal tumors (GISTs), 10-year experience: patterns of failure and prognostic factors for survival of 127 patients. J Egypt Natl Cancer Inst. 2012;24(1):31–9.

    CAS  Google Scholar 

  38. Al-Thani H, El-Menyar A, Rasul KI, Al-Sulaiti M, El-Mabrok J, Hajaji K, et al. Clinical presentation, management and outcomes of gastrointestinal stromal tumors. Int J Surg. 2014;12(10):1127–33.

    PubMed  Google Scholar 

  39. Jumniensuk C, Charoenpitakchai M. Gastrointestinal stromal tumor: clinicopathological characteristics and pathologic prognostic analysis. World J Surg Oncol. 2018;16(1):231.

    PubMed  PubMed Central  Google Scholar 

  40. Menge F, Jakob J, Kasper B, Smakic A, Gaiser T, Hohenberger P. Clinical presentation of gastrointestinal stromal tumors. Visc Med. 2018;34(5):335–40.

    PubMed  PubMed Central  Google Scholar 

  41. Gönüllü D, Demiray O, İlgün S, Yıldız UM, Gedik ML, Er M, et al. Gastrointestinal stromal tumors: a clinical and histopathological presentation of 27 cases. Turk J Surg. 2018;34(4):259–63.

    PubMed  PubMed Central  Google Scholar 

  42. Yacob M, Inian S, Sudhakar CB. Gastrointestinal stromal tumours: review of 150 cases from a single centre. Indian J Surg. 2015;77(Suppl 2):505–10.

    PubMed  Google Scholar 

  43. Varshney VK, Gupta RK, Saluja SS, Tyagi I, Mishra PK, Batra VV. Analysis of clinicopathological and immunohistochemical parameters and correlation of outcomes in gastrointestinal stromal tumors. Indian J Cancer. 2019;56(2):135–43.

    PubMed  Google Scholar 

  44. Espinosa I, Lee C-H, Kim MK, Rouse B-T, Subramanian S, Montgomery K, et al. A novel monoclonal antibody against DOG1 is a sensitive and specific marker for gastrointestinal stromal tumors. Am J Surg Pathol. 2008;32(2):210–8.

    PubMed  Google Scholar 

  45. Liegl B, Hornick JL, Corless CL, Fletcher CDM. Monoclonal antibody DOG1.1 shows higher sensitivity than KIT in the diagnosis of gastrointestinal stromal tumors, including unusual subtypes. Am J Surg Pathol. 2009;33(3):437–46.

    PubMed  Google Scholar 

  46. Lopes LF, West RB, Bacchi LM, van de Rijn M, Bacchi CE. DOG1 for the diagnosis of gastrointestinal stromal tumor (GIST): Comparison between 2 different antibodies. Appl Immunohistochem Mol Morphol. 2010;18(4):333–7.

    PubMed  Google Scholar 

  47. Lopes LF, Ojopi EB, Bacchi CE. Gastrointestinal stromal tumor in Brazil: clinicopathology, immunohistochemistry, and molecular genetics of 513 cases. Pathol Int. 2008;58(6):344–52.

    PubMed  Google Scholar 

  48. Lee C-H, Liang C, Espinosa I. The utility of discovered on gastrointestinal stromal tumor 1 (DOG1) antibody in surgical pathology-the GIST of it. Adv Anat Pathol. 2010;17(3):222–32.

    CAS  PubMed  Google Scholar 

  49. Wada T, Tanabe S, Ishido K, Higuchi K, Sasaki T, Katada C, et al. DOG1 is useful for diagnosis of KIT-negative gastrointestinal stromal tumor of stomach. World J Gastroenterol. 2013;19(47):9133–6.

    PubMed  PubMed Central  Google Scholar 

  50. Yamamoto H, Kojima A, Nagata S, Tomita Y, Takahashi S, Oda Y. KIT-negative gastrointestinal stromal tumor of the abdominal soft tissue: a clinicopathologic and genetic study of 10 cases. Am J Surg Pathol. 2011;35(9):1287–95.

    PubMed  Google Scholar 

  51. Bartalucci A, Pouli E, Fregoli L, Cremonini C, Basolo F, Miccoli P, et al. Molecular genetic features and risk assessment in a series of 30 patients who underwent an operation for gastrointestinal stormal tumours. South Afr J Surg. 2016;54(1):23–7.

    CAS  Google Scholar 

  52. Bachmann R, Strohäker J, Kraume J, Königsrainer A, Ladurner R. Surgical treatment of gastrointestinal stromal tumours combined with imatinib treatment: a retrospective cohort analysis. Transl Gastroenterol Hepatol. 2018;3:108.

    PubMed  PubMed Central  Google Scholar 

  53. Bareck E, Ba-Ssalamah A, Brodowicz T, Eisterer W, Häfner M, Högenauer C, et al. Gastrointestinal stromal tumors: diagnosis, therapy and follow-up care in Austria. Wien Med Wochenschr 1946. 2013;163(5–6):137–52.

    Google Scholar 

  54. Demetri GD, von Mehren M, Antonescu CR, DeMatteo RP, Ganjoo KN, Maki RG, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Cancer Netw. 2010;8(Suppl 2):S1–41 quiz S42-44.

    CAS  Google Scholar 

  55. Sakin A, Can O, Arici S, Yasar N, Geredeli C, Demir C, et al. Factors affecting disease-free survival in operated nonmetastatic gastrointestinal stromal tumors. J Surg Res. 2019;241:170–7.

  56. Wang M, Xue A, Yuan W, Gao X, Fu M, Fang Y, et al. Clinicopathological features and prognosis of small gastric gastrointestinal stromal tumors (GISTs). J Gastrointest Surg. 2019;22.

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Acknowledgements

We thank all the authors whose publications and patients we have used in this study and for helping to clarify patient overlap when such arose during the study.

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Authors and Affiliations

  1. Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria

    Gabriel O. Ogun & Omolade O. Adegoke

  2. Department of Pathology, University College Hospital, Ibadan, Nigeria

    Gabriel O. Ogun, Omolade O. Adegoke & Adam Rahman

  3. Department of Anatomical Pathology, College of Medical Sciences, Edo University Iyamho, Iyamho, Nigeria

    Ojevwe H. Egbo

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  1. Gabriel O. Ogun
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  2. Omolade O. Adegoke
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  3. Adam Rahman
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  4. Ojevwe H. Egbo
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Correspondence to Gabriel O. Ogun.

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This study was conducted in compliance with the guidelines of the Helsinki declaration on biomedical research in human subjects. Confidentiality of the identity of the patients and personal health information was maintained.

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The authors declare that they have no conflict of interest.

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Ogun, G.O., Adegoke, O.O., Rahman, A. et al. Gastrointestinal Stromal Tumours (GIST): A Review of Cases from Nigeria. J Gastrointest Canc 51, 729–737 (2020). https://doi.org/10.1007/s12029-019-00318-6

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