Gastrointestinal stromal tumor: clinicopathological characteristics and pathologic prognostic analysis

• Published in: World journal of surgical oncology Vol. 16; no. 1; p. 231
• Main Authors: Jumniensuk, Chayanit, Charoenpitakchai, Mongkon
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03-12-2018; BioMed Central; BMC
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bleeding; Cancer; Care and treatment; Cell size; Correlation; Data processing; Diagnosis; Female; Gangrene; Gastric Mucosa - pathology; Gastrointestinal cancer; Gastrointestinal stromal tumor; Gastrointestinal Stromal Tumors - mortality; Gastrointestinal Stromal Tumors - pathology; GIST; Humans; Kaplan-Meier Estimate; Lymphatic system; Male; Medical prognosis; Metastases; Metastasis; Middle Aged; Morphology; Mucosa; Mutation; Necrosis; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - pathology; Pathology; Prognosis; Progression-Free Survival; Recurrence (Disease); Retrospective Studies; Risk factors; Stomach; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Studies; Thailand - epidemiology; Tumors; Young Adult; Thailand; GIST; Gastrointestinal stromal tumor
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-018-1532-1

This study aimed to understand clinicopathological characteristics of gastrointestinal stromal tumors (GISTs) and correlation between pathologic features and clinical outcome.
We used 76 cases diagnosed as primary GISTs during January 2007 to July 2017 at Army Institute of Pathology, Thailand. Clinical, survival, and pathological data were collected and analyzed.
Ages of the patients ranged from 15 to 88 years (M:F = 1:1). The most common presentation was gastrointestinal bleeding (39.7%). The most common site was the stomach (64.5%). Tumor size ranged from 0.6 to 25.5 cm (average 8.78 cm). Histologic types were spindle cell type (75%), mixed spindled-epithelioid type (17.1%), and epithelioid type (7.9%). The majority of histologic subtype was diffuse hypercellularity (67.1%). Tumor necrosis was found in 38.1% and 80% showed low mitotic counts. Most gastrointestinal stromal tumors (27.6%) are low-risk category according to Miettinen and Lasota's algorithm. Metastasis was found in 27.7%, mostly occurs within 2 years, and is correlated with tumor size > 10 cm (P = 0.023), non-spindle cell histologic type (P = 0.027), mitotic count > 5/5mm
(P = 0.000), myxoid change (P = 0.011), and mucosal invasion (P = 0.002). Recurrence was found in 8.1%, mostly occurs within 7 years, and correlated with myxoid change (P = 0.045).
We found that most of GISTs show spindle cell type and low-risk category. Metastasis was correlated with tumor size > 10 cm, non-spindle cell histologic type, mitotic count > 5/5mm
, myxoid change, and mucosal invasion. Recurrence was correlated with myxoid change.