Gastrointestinal stromal tumors: Factors affecting prognosis and single-center surgery results

Abstract

Aim: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. The aim of this study was to investigate the clinical features and histopathological findings of GIST cases who underwent surgical treatment in our clinic in terms of prognostic criteria. Material and Methods: The patients operated for GIST between January 1, 2007 and May 31, 2014 were included in this study. Demographic data, presenting symptoms, ASA scores, diagnostic methods, tumor localizations, use of imatinib before surgery, surgical treatment methods, postoperative complications, tumor size, mitotic activity, immunohistochemical markers, prognostic risk classification, follow-up periods, use of imatinib after surgery, recurrence status and survival data were examined Results: A total of 60 patients were included in the study. The median age was 56.5 (29-81) years . Fifty five of patients were males. Synchronous tumors in more than one location existed in approximately 7% of the patients. The surgical margin was positive in 14 (23.3%) patients after the surgical procedure. The recurrence and metastasis rates of these patients were 14.3% and 42.8%, respectively. On the other hand, these rates were 10.8% and 17.3% respectively in the patients with negative surgical margin. The expected 5-year survival rates according to the risk classification was 66.7% for very low-risk patients, 85.7% for low-risk patients, 59.7% for moderate-risk patients and 47.7% for high-risk patients. Conclusion: GISTs have relatively good prognosis compared to epithelial malignant tumors but require long-term follow-up. In addition, satisfactory results can be obtained with the use of tyrosine kinase inhibitors and adequate surgical margins