European Journal of Molecular & Clinical Medicine

Abstract

Background and aims: Gastrointestinal stromal tumours (GISTs) are the most common
mesenchymal neoplasms that arise in the gastrointestinal tract.They constitute about
0.1-3% of all GI tumours. Annual incidence is 1.2 per 105 individuals. Surgery remains
the main stay of treatment. The use of adjuvant TKI Imatinib mesylate for 3 years
reduce the frequency of disease recurrencefollowing complete resection.Five year
survival for all stages combined is upto 83%.Here we present a five year retrospective
data on the clinicopathological features and outcomes of GIST from a tertiary cancer
care centre in south India.
Methods: This retrospective study was conducted in a tertiary cancer care centre in
South India.Medical records of all consecutive patients with biopsy and IHC
(Immunohistochemistry) proven GIST cases from January 2017 to December 2021 were
collected, reviewed and analysed .
Results: 38 cases of biopsy and IHC proven GISTs were analysed. Median age was 54
years. 20 were males and 18 were females .The most common primary site was
stomach(45%) followed by small intestine(39%).Majority of the patients were stage III
at presentation (53%). 26 of cases were metastatic at presentation. Primary surgery was
offered in 55% of the patients.68% of the patients received adjuvant treatment with
Imatinib. 83 % of patients (10/12) who completed 3 years of adjuvant treatment
remained disease free and 82% of all patients (31/38) are alive at the time of analysis.
There was no progression in stage IV GISTs treated with Imatinib. 31% of patients
developed GI toxicity with imatinib. Recurrence was seen in only 4 patients (14%) who
received adjuvant TKI (Tyrosine kinase inhibitors). Common sites of recurrence was
liver (50%) and omental and peritoneal secondaries.(50%).Progression on second line
therapy with Sunitinib was seen only in one case of recurrent GIST.
Conclusion: Adjuvant Imatinib is efficacious and is well tolerated by our
population.83% of the patients who completed adjuvant therapy are disease free at 2
years.5 year survival rate is about 82%.There is no grade 3 or 4 toxicity with Imatinib.