Clinical presentation, management and outcomes of gastrointestinal stromal tumors

• Published in: International journal of surgery (London, England) Vol. 12; no. 10; pp. 1127 - 1133
• Main Authors: Al-Thani, Hassan, El-Menyar, Ayman, Rasul, Kakil Ibrahim, Al-Sulaiti, Maryam, El-Mabrok, Jamela, Hajaji, Khairi, Elgohary, Hesham, Tabeb, AbdelHakem
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2014
• Subjects: Adult; Aged; Chemotherapy, Adjuvant - statistics & numerical data; Complications; Female; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - epidemiology; Gastrointestinal Neoplasms - therapy; Gastrointestinal Stromal Tumors - diagnosis; Gastrointestinal Stromal Tumors - epidemiology; Gastrointestinal Stromal Tumors - therapy; GIST; Humans; Incidence; Laparoscopy - statistics & numerical data; Liver Neoplasms - secondary; Male; Management; Middle Aged; Neoplasm Recurrence, Local; Outcome; Qatar - epidemiology; Retrospective Studies; Robotic Surgical Procedures - statistics & numerical data; Surgery; Tumor size; Young Adult; Qatar; PDGFRA; PDT; GIST; magnetic resonance imaging; high power fields; Armed Forces Institute of Pathology; Complications; MRI; Tumor size; SMA; photodynamic therapy; gastrointestinal stromal tumors; Management; National Institutes of Health; NIH; AFIP; platelet derived growth factor receptor α; Hamad Medical Corporation; Outcome; smooth muscle actin; HMC; HPF
• ISSN: 1743-9191; 1743-9159
• DOI: 10.1016/j.ijsu.2014.08.351

Abstract Introduction : The present study investigated the incidence, management and outcome of Gastrointestinal Stromal Tumors (GIST) in Qatar. Methods : A retrospective review of all GIST patients admitted between 1995 and 2012 was conducted. Patients' demographics, clinical presentation, tumor characteristics, radiological, pathological and immunohistochemical findings, surgical procedures, recurrence and mortality were recorded. Results : A total of 48 GIST patients were identified. Stomach (56%) and small intestine (27%) were the most common sites of tumor. The majority of cases ( n  = 27) had tumor size >5 cm, 31 cases had primary and 15 cases had locally advanced tumor. Patients were stratified as high, intermediate, and low risk (43.8%, 18.8% and 37.5%, respectively). Almost all the cases were surgically managed and 94% were completely resectable. Robotic partial resection was performed in 4 cases and 5 cases underwent laparoscopic resection. Chemotherapy was initiated in half of patients. During follow up (average 37.5 months), 33 patients showed complete recovery, 7 had recurrent or metastatic disease and 2 died due to liver metastasis. Conclusion : The incidence of GIST in Qatar is apparently low. Surgical resection is the preferred choice of treatment; however, robotic and laparoscopic resections are feasible and safe approaches in some cases.