Original Article
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World J Gastrointest Oncol. Nov 15, 2012; 4(11): 216-222
Published online Nov 15, 2012. doi: 10.4251/wjgo.v4.i11.216
Clinical outcomes of gastrointestinal stromal tumor in southern Thailand
Kittima Pornsuksiri, Siripong Chewatanakornkul, Samornmas Kanngurn, Wanwisa Maneechay, Walawee Chaiyapan, Surasak Sangkhathat
Kittima Pornsuksiri, Siripong Chewatanakornkul, Walawee Chaiyapan, Surasak Sangkhathat, Department of Surgery and Tumor Biology Research Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Samornmas Kanngurn, Anatomical Pathology Unit, Department of Pathology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Wanwisa Maneechay, Central Molecular Research Laboratory, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
Author contributions: All the authors contributed to this manuscript.
Correspondence to: Surasak Sangkhathat, MD, PhD, Associate Professor, Department of Surgery and Tumor Biology Research Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. surasak.sa@psu.ac.th
Telephone: +66-7445-1401 Fax: +66-7442-9384
Received: May 11, 2012
Revised: September 4, 2012
Accepted: October 20, 2012
Published online: November 15, 2012
Abstract

AIM: To review a single institutional experience in clinical management of gastrointestinal stromal tumors (GIST) and analyze for factors determining treatment outcome.

METHODS: Clinicopathological data of patients with a diagnosis of GIST who were treated at our institute during November 2004 to September 2009 were retrospectively reviewed.

RESULTS: Ninety-nine cases were included in the analysis. Primary tumor sites were at the stomach in and small bowel in 44% and 33%, respectively. Thirty-one cases already had metastasis at presentation and the most common metastatic site was the liver. Sixty-four cases (65%) were in the high-risk category. Surgical treatment was performed in 77 cases (78%), 3 of whom received upfront targeted therapy. Complete resection was achieved in 56 cases (73% of operative cases) and of whom 27 developed local recurrence or distant metastasis at a median duration of 2 years. Imatinib was given as a primary therapy in unresectable cases (25 cases) and as an adjuvant in cases with residual tumor (21 cases). Targeted therapy gave partial response in 7 cases (15%), stable disease in 27 cases (57%) and progressive disease in 13 cases (28%). Four-year overall survival was 74% (95% CI: 61%-83%). Univariate survival analysis found that low-risk tumor, gastric site, complete resection and response to imatinib were associated with better survival.

CONCLUSION: The overall outcomes of GIST can be predicted by risk-categorization. Surgery alone may not be a curative treatment for GIST. Response to targeted therapy is a crucial survival determinant in these patients.

Keywords: Gastrointestinal stromal tumor, Targeted therapy, Overall survival, Progress free survival, Progressive disease