Clinicopathologic Characteristics and Prognostic Factors of GIST: NCI 5-year Experience. | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 18, Issue 3, July 2025, Page 212-220 PDF (388.71 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/asjs.2025.383294.1200 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Alaadin Hussien  ; Abdelrahman Elmasry; Mohamed Aly Abdelhamed
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| Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo, Egypt | ||||
| Abstract | ||||
| Introduction: Gastrointestinal stromal tumors (GISTs) are considered the most prevelant mesenchymal tumors in the gastrointestinal system. Aim of work: This study aims to evaluate the prognostic variables and clinicopathological features in GIST patients treated in the national cancer institute. Patients and methods: Ninety non-metastatic GISTs treated with curative surgery between January 2016 and December 2020, were the subject of a retrospective investigation. The Cox regression model and the Kaplan-Meier technique were used to evaluate survival analysis. Results: The mean age was 59.4±13.3 years, 48.9% were males. Tumors were gastric (77.8%), jejunal and ileal (10%) duodenal (6.7%), and rectal (4.4%). Spindle cell tumors constituted 90%. The median mitotic index was 6/50 HPF (1-14), and 49% were > 5. Cases were low-risk (16.7%), intermediate-risk (22.2%), and high-risk (61.1%). Most samples tested positive for CD117 (94.4%) and DOG1 (98.3%). Imatinib was used in 14 patients (15.6%) as neoadjuvant and as adjuvant therapy in 65 (72.2%). The 3-year OS and DFS rates were 92.2% (95% CI: 86.9–99.3) and 70.9% (95% CI: 60.7–82.7), respectively. Rectal tumors showed significantly worse OS (P=0.026). Larger tumor size, non-gastric location, mixed histological subtype, high risk, tumor rupture, and higher mitotic rate were associated with worse DFS. Tumor location was the only independent factor affecting DFS. Conclusion: GISTs were mostly gastric and intermediate to high risk. Imatinib was more commonly used as adjuvant therapy. Rectal tumors had significantly worse overall survival. Large tumors, non-gastric, mixed histological subtype, high risk, tumor rupture, and higher mitotic rate were associated with worse disease-free survival. | ||||
| Keywords | ||||
| GIST; gastrointestinal stromal tumors; small intestine; imatinib therapy; KIT | ||||
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