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  • Title: Synchronous gastrointestinal cancer and gastrointestinal stromal tumors: a single-institution experience.
    Author: Du J, Shen N, He HS, Fu XL, Wang JZ, Mao CZ.
    Journal: World J Surg Oncol; 2016 Apr 29; 14():130. PubMed ID: 27129592.
    Abstract:
    BACKGROUND: A study was conducted to investigate the clinicopathological features and survival outcomes of gastrointestinal stromal tumors (GISTs) that are synchronous with other gastrointestinal cancers. METHODS: Clinical and pathological data of 286 patients with primary GIST from a single institution from January 2009 to December 2014 were reviewed. RESULTS: The entire study population comprised 286 patients with GISTs. Of these patients, 167 (58.4%) were males and 119 (41.6%) were females. The median age was 58 years old (in the range 29-86 years). A total of 47 patients were diagnosed with GISTs synchronous with other digestive tract malignancies (synchronous group), whereas 239 patients were diagnosed with non-synchronous disease (non-synchronous group). The concomitant digestive tumors in 27, 12, 7, and 1 patients were diagnosed as gastric carcinoma, esophageal carcinoma, colorectal carcinoma, and pancreatic adenocarcinoma, respectively. Compared with the synchronous group, the non-synchronous group exhibited a higher percentage of increased mitotic count (P = 0.011). The difference in tumor diameter between the two groups was statistically significant (P < 0.001). Patients in the non-synchronous group exhibited larger tumor size than the patients in the synchronous group (5.9 ± 3.5 cm vs. 1.6 ± 0.4 cm, P < 0.001). The majority of GIST lesions in the synchronous group were located in the stomach (P = 0.020). Lower risk stratifications and worse ECOG performance statuses were observed in the synchronous group (P < 0.001) than in the non-synchronous group. The 5-year overall survival rate was significantly higher in patients with no synchronous digestive tract malignancies than in patients with synchronous disease (70.8 vs. 34.1%, P < 0.001). CONCLUSIONS: Patients with GIST synchronous with other gastrointestinal cancers show worse prognosis than those with non-synchronous tumors. Clinicians should pay more attention to this subgroup.
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