Introduction Gastrointestinal Stromal Tumours (GISTs) are tumours of mesenchymal origin that arise in the GI tract and account for approximately 0.1 to 3% of all gastrointestinal tumours. The aim of this study was to determine the relative incidence, clinical features and treatment outcome of GISTs diagnosed by a regional upper GI cancer network.
Method One hundred and sixty one consecutive patients were identified through the regional upper GI cancer network. The median age was 66 (range 20–91) years; 86 male, 75 female. The primary outcome measure was survival.
Results The anatomical distribution of the tumours was: gastric 74%; small bowel 15%; colorectal 3.8%; oesophageal 2.5%; unknown primary site 4.7%. Ninety-four (58.4%) underwent surgical resection. Thirteen were endoscopic (13.8%). Immunohistochemistry staining was performed on 46.6%, of which 89% were CD117 positive and 49.3% were CD34 positive. Malignant potential was recorded in 45.3% of cases: 12.4% benign; 14.3% low/low-intermediate; 8.7% intermediate; 3.7% high; 6.2% malignant. Overall 5- and 10- year survival was 79% and 53% respectively. Recurrent disease was identified in 6.8% of patients and progressive disease in 7.5%. Rectal and gastric GISTs had the poorest 5- and 10- year survival (p = 0.04). The median size of resected tumours was 5 cm (range 0.4 to 26 cm), and univariate analysis showed an association with survival (Chi214.755, p = 0.005). On multivariable analysis, maximum dimension of resected tumour was the only variable independently associated with survival (HR 1.107, 95% CI 1.035–1.184, p = 0.03).
Conclusion The majority of GISTs diagnosed were upper GI (76.5%). Five- and ten- year survival rates are longer than for other upper GI cancers and clinicians should be aware of this when counselling patients and planning management.
Disclosure of interest None Declared.
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