Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 21, 2020; 26(47): 7550-7567
Published online Dec 21, 2020. doi: 10.3748/wjg.v26.i47.7550
Clinical features of multiple gastrointestinal stromal tumors: A pooling analysis combined with evidence and gap map
Chen Li, Ke-Lu Yang, Quan Wang, Jin-Hui Tian, Yang Li, Zhi-Dong Gao, Xiao-Dong Yang, Ying-Jiang Ye, Ke-Wei Jiang
Chen Li, Quan Wang, Yang Li, Zhi-Dong Gao, Xiao-Dong Yang, Ying-Jiang Ye, Ke-Wei Jiang, Department of Gastroenterological Surgery, Peking University People's Hospital, Beijing 100044, China
Ke-Lu Yang, Evidence-Based Nursing Center, School of Nursing, Lanzhou University, Lanzhou 730000, Gansu Province, China
Jin-Hui Tian, Evidence Based Medicine Center, School of Basic Medical Science of Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Li C and Yang KL contributed equally to design the research and wrote the paper; Tian JH and Wang Q supervised the research and contributed to analysis; Li Y, Gao ZD, Yang XD, and Ye YJ provided the clinical advice and supervised the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Peking University People’s Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. The sample of informed consent had already uploaded.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Ke-Wei Jiang, MD, PhD, Adjunct Professor, Chairman, Chief Doctor, Director, Surgeon, Surgical Oncologist, Department of Gastroenterological Surgery, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China.
Received: September 12, 2020
Peer-review started: September 12, 2020
First decision: October 27, 2020
Revised: November 9, 2020
Accepted: November 21, 2020
Article in press: November 21, 2020
Published online: December 21, 2020
Research background

Multiple gastrointestinal stromal tumors (MGISTs) is a very rare type of gastrointestinal stromal tumor (GIST) and is usually misdiagnosed as metastatic tumors.

Research motivation

As physicians become more aware of MGISTs, researchers believed that it was imperative to describe MGISTs to help surgeons make appropriate diagnosis and treatment.

Research objectives

The study aimed to describe the clinical and oncological features of MGISTs and to offer evidence for MGISTs diagnosis and treatment.

Research methods

Data of consecutive patients with MGISTs who were diagnosed at Peking University People’s Hospital (PKUPH) from 2008 to 2019 were retrospectively evaluated. Further, a literature search was conducted by retrieving data from PubMed, EMBASE, and the Cochrane library databases from inception up to November 30, 2019.

Research results

In all, 12 patients were diagnosed with MGISTs at PKUPH, and 43 published records were ultimately included following literature review. Combined analysis of all the individual patient data showed that female (59.30%), young (14.45%), and syndromic GIST (63.95%) patients comprised a large proportion of the total patient population. Tumors were mainly located in the small intestine (58.92%), and both CD117 and CD34 were generally positive. After a mean 78.32-mo follow-up, the estimated median overall survival duration (11.5 years) was similar to single GISTs, but recurrence-free survival was relatively poorer.

Research conclusions

The clinical and oncological features are potentially different between MGISTs and single GIST, such as lower morbidity, female predominance, young age, multiple organ involvement, and possible syndromic GIST. Although overall survival was similar between single GISTs and MGISTs, a high rate of metastasis in MGIST patients resulted in a poorer long-time RF survival rate.

Research perspectives

In further studies, focusing on gene detection and molecular biological analysis can contribute to the understanding of the mechanism underlying this special type of GIST in future studies. Moreover, an appropriate surgical approach and auxiliary therapy are urgently need to be determined by prospective, multicenter, and large-scale studies.