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Clinicopathologic factors predicting outcomes in patients with gastrointestinal stromal tumors of the rectum and colon

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Tumor Biology

Abstract

Limited information is available concerning the clinicopathologic profile of colorectal gastrointestinal stromal tumors (GISTs), which are relatively rare, as well as survival rates following surgical resection. The present study was designed to describe the clinicopathologic characteristics of patients with colorectal GISTs and identify potential factors that may predict postoperative survival outcomes. We reviewed the medical records of 67 patients with colorectal GISTs who underwent surgical resection between January 2000 and December 2012. Clinicopathologic factors affecting overall survival were assessed using the Kaplan-Meier method and multivariate Cox proportional hazards models. The median age at diagnosis was 57 years (range, 32–79 years), with a male-to-female ratio of 1.68. Tumor size varied from 0.2 to 11 cm, with a median size of 5.7 cm. Sixty-two tumors (93 %) were positive for CD117, 53 (79 %) for CD34, 6 (9 %) for PDGFRA, 15 (22 %) for SMA, 5 (8 %) for S100, and 39 (58 %) for vimentin. The overall median survival time was 54 months (95 % confidence interval, 32–59 months), and the 1-, 3-, and 5-year overall survival rates were 89.6, 63.9, and 34.4 %, respectively. High-risk tumors (determined by histologic grade, size, and other histologic variables) were associated with poor prognosis (hazard ratio, 1.83; 95 % confidence interval, 1.21–2.78), and patients who received adjuvant treatment with imatinib had significantly longer median overall survival times than patients who did not (hazard ratio, 0.43; 95 % confidence interval, 0.24–0.80). In patients with colorectal GISTs, high-risk tumor histologic grade can predict poor prognosis, and patients may benefit from adjuvant treatment with imatinib. Findings from the present study may provide information to establish evidence-based management strategies for colorectal GISTs.

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References

  1. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumours. Ann Chir Gynaecol. 1998;87(4):278–81.

    CAS  PubMed  Google Scholar 

  2. Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol. 1999;30(10):1213–20.

    Article  CAS  PubMed  Google Scholar 

  3. Kisluk J, Gryko M, Guzinska-Ustymowicz K, Kemona A, Kedra B. Immunohistochemical diagnosis of gastrointestinal stromal tumors—an analysis of 80 cases from 2004 to 2010. Adv Clin Exp Med. 2013;22(1):33–9.

    PubMed  Google Scholar 

  4. Miettinen M, Sarlomo-Rikala M, Sobin LH, Lasota J. Gastrointestinal stromal tumors and leiomyosarcomas in the colon: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases. Am J Surg Pathol. 2000;24(10):1339–52.

    Article  CAS  PubMed  Google Scholar 

  5. Bamboat ZM, Dematteo RP. Updates on the management of gastrointestinal stromal tumors. Surg Oncol Clin N Am. 2012;21(2):301–16. doi:10.1016/j.soc.2011.12.004.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Rammohan A, Sathyanesan J, Rajendran K, Pitchaimuthu A, Perumal SK, Srinivasan U, et al. A gist of gastrointestinal stromal tumors: a review. World J Gastrointest Oncol. 2013;5(6):102–12. doi:10.4251/wjgo.v5.i6.102.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Xiao CC, Zhang S, Wang MH, Huang LY, Wu P, Xu Y, et al. Clinicopathological features and prognostic factors of rectal gastrointestinal stromal tumors. J Gastrointest Surg. 2013;17(4):793–8. doi:10.1007/s11605-012-2086-0.

    Article  CAS  PubMed  Google Scholar 

  8. Macias-Garcia F, Parada P, Martinez-Lesquereux L, Pintos E, Fraga M, Dominguez-Munoz JE. Gastrointestinal stromal tumors (GISTs) of the colon. Rev Esp Enferm Dig. 2010;102(6):388–90.

    Article  CAS  PubMed  Google Scholar 

  9. Hassan I, You YN, Dozois EJ, Shayyan R, Smyrk TC, Okuno SH, et al. Clinical, pathologic, and immunohistochemical characteristics of gastrointestinal stromal tumors of the colon and rectum: implications for surgical management and adjuvant therapies. Dis Colon Rectum. 2006;49(5):609–15. doi:10.1007/s10350-006-0503-8.

    Article  PubMed  Google Scholar 

  10. Hassan I, You YN, Shyyan R, Dozois EJ, Smyrk TC, Okuno SH, et al. Surgically managed gastrointestinal stromal tumors: a comparative and prognostic analysis. Ann Surg Oncol. 2008;15(1):52–9. doi:10.1245/s10434-007-9633-z.

    Article  PubMed  Google Scholar 

  11. Dematteo RP, Gold JS, Saran L, Gonen M, Liau KH, Maki RG, et al. Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST). Cancer. 2008;112(3):608–15. doi:10.1002/cncr.23199.

    Article  PubMed  Google Scholar 

  12. Martin J, Poveda A, Llombart-Bosch A, Ramos R, Lopez-Guerrero JA, Garcia del Muro J, et al. Deletions affecting codons 557–558 of the c-KIT gene indicate a poor prognosis in patients with completely resected gastrointestinal stromal tumors: a study by the Spanish Group for Sarcoma Research (GEIS). J Clin Oncol. 2005;23(25):6190–8.

    Article  CAS  PubMed  Google Scholar 

  13. Miettinen M, Lasota J. Gastrointestinal stromal tumors—definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch. 2001;438(1):1–12.

    Article  CAS  PubMed  Google Scholar 

  14. Shi Y, Hou YY, Lu SH, Zhou Y, Xu JF, Ji Y, et al. Clinical and pathological studies of borderline gastrointestinal stromal tumors. Chin Med J (Engl). 2010;123(18):2514–20.

    PubMed  Google Scholar 

  15. Bulbul DG. Gastrointestinal stromal tumors: a multicenter study of 1160 Turkish cases. Turk J Gastroenterol. 2012;23(3):203–11.

    Article  Google Scholar 

  16. Boni L, Benevento A, Dionigi G, Rovera F, Dionigi R. Surgical resection for gastrointestinal stromal tumors (GIST): experience on 25 patients. World J Surg Oncol. 2005;3:78. doi:10.1186/1477-7819-3-78.

    Article  PubMed  PubMed Central  Google Scholar 

  17. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231(1):51–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Ng EH, Pollock RE, Munsell MF, Atkinson EN, Romsdahl MM. Prognostic factors influencing survival in gastrointestinal leiomyosarcomas. Implications for surgical management and staging. Ann Surg. 1992;215(1):68–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Int J Surg Pathol. 2002;10(2):81–9.

    Article  PubMed  Google Scholar 

  20. Theodoropoulos DG. Gastrointestinal tumors of the colon and rectum. Clin Colon Rectal Surg. 2011;24(3):161–70. doi:10.1055/s-0031-1286000.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Wu TJ, Lee LY, Yeh CN, Wu PY, Chao TC, Hwang TL, et al. Surgical treatment and prognostic analysis for gastrointestinal stromal tumors (GISTs) of the small intestine: before the era of imatinib mesylate. BMC Gastroenterol. 2006;6:29. doi:10.1186/1471-230X-6-29.

    Article  PubMed  PubMed Central  Google Scholar 

  22. El-Zohairy M, el Khalil SA, Fakhr I, El-Shahawy M, Gouda I. Gastrointestinal stromal tumor (GIST)’s surgical treatment, NCI experience. J Egypt Natl Canc Inst. 2005;17(2):56–66.

    PubMed  Google Scholar 

  23. Linch M, Claus J, Benson C. Update on imatinib for gastrointestinal stromal tumors: duration of treatment. Onco Targets Ther. 2013;6:1011–23. doi:10.2147/OTT.S31260.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Tielen R, Verhoef C, van Coevorden F, Gelderblom H, Sleijfer S, Hartgrink HH, et al. Surgery after treatment with imatinib and/or sunitinib in patients with metastasized gastrointestinal stromal tumors: is it worthwhile? World J Surg Oncol. 2012;10:111. doi:10.1186/1477-7819-10-111.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651# DongFeng East Road, GuangZhou, 510060, China

    Zhongguo Zhou & Minshan Chen

  2. Department of General Surgery, The 5th People’s Hospital of Foshan City, 63# Jiangpu East Road, Nanhai District, FoShan, 528211, China

    Zhanpeng Chen

  3. Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-sen University, 74# Zhongshan Er Lu, Guangzhou, 510089, China

    Ruojing Wang

  4. Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 96 Dong Chuan Lu, Guangzhou, 510080, China

    Ying Yin & Yuan Yao

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  1. Zhongguo Zhou
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  2. Zhanpeng Chen
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  3. Minshan Chen
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  4. Ruojing Wang
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  5. Ying Yin
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  6. Yuan Yao
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Corresponding author

Correspondence to Yuan Yao.

Additional information

Zhongguo Zhou and Zhanpeng Chen contributed to this work equally.

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Zhou, Z., Chen, Z., Chen, M. et al. Clinicopathologic factors predicting outcomes in patients with gastrointestinal stromal tumors of the rectum and colon. Tumor Biol. 35, 4357–4362 (2014). https://doi.org/10.1007/s13277-013-1572-7

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  • DOI: https://doi.org/10.1007/s13277-013-1572-7

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