Clinicopathological features and prognosis of mesenteric gastrointestinal stromal tumor: evaluation of a pooled case series.

Guanghui Xu,Hongwei Zhang,Bin Feng,Daiming Fan,Zhen Liu,Man Guo,Xiao Lian,Shushang Liu,Fan Feng

doi:10.18632/oncotarget.14880

Guanghui Xu, Hongwei Zhang + Show 7 more

Open Access

https://doi.org/10.18632/oncotarget.14880

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Journal: Oncotarget	Publication Date: Jan 28, 2017
Citations: 16	License type: cc-by

Affiliation: Air Force Medical University

Abstract

BackgroundDue to the extremely rare incidence, data of clinicopathological features and prognosis of mesenteric gastrointestinal stromal tumors (GISTs) are limited. Therefore, the aim of the present study was to investigate the clinicopathological features and prognosis of mesenteric GISTs.Patients and MethodsMesenteric GISTs cases were obtained from our center and from case reports and clinical series extracted from MEDLINE. Clinicopathological features and survivals were analyzed.ResultsA total of 114 mesenteric GISTs were enrolled in present study. The most common symptom was abdominal pain (20/72, 27.8%), followed by abdominal mass (13/72, 18.1%) and distention (9/72, 12.5%). Most tumors exceeded 10 cm in diameter (71/112, 63.4%), exceeded 5/50HPF in mitotic index (50/85, 58.8%), and were high risk (82/90, 91.1%). The five-year disease free survival (DFS) and disease specific survival (DSS) was 57.7% and 60.1%, respectively. Tumor size and mitotic index were associated with DFS and DSS. The distribution of tumor size, histological type, mitotic index and NIH risk category were significantly different between mesenteric and gastric GISTs. Prognosis of mesenteric GISTs was worse than that of gastric GISTs. However, multivariate analysis showed that location was not an independent prognostic factor for mesenteric and gastric GISTs.ConclusionsMost mesenteric GISTs exceeded 10 cm in diameter, exceeded 5/50HPF in mitotic index and were high risk. Mesenteric GISTs differed significantly from gastric GISTs in respect to clinicopathologic features. Mitotic index and tumor size were prognostic factors for mesenteric GISTs. The prognosis were comparable between mesenteric and gastric GISTs.

Highlights

Gastrointestinal stromal tumors (GISTs) are the commonest mesenchymal neoplasms of the gastrointestinal (GI) tract and represent 1-2% of all GI malignancies [1]
CD117 positivity was detected in 46 patients (46/50, 92.0%), Discovered on GIST 1 (DOG-1) positivity was detected in 10 patients (10/11, 91.0%)
GISTs cases of the mesentery were from our institution and literature

Summary

Introduction

Gastrointestinal stromal tumors (GISTs) are the commonest mesenchymal neoplasms of the gastrointestinal (GI) tract and represent 1-2% of all GI malignancies [1]. GISTs are considered to arise from the interstitial cells of Cajal (ICC) [2]. Most GISTs displayed spindle cell morphology (70%), followed by epithelioid (20%) and mixed phenotypes (10%) [3]. GISTs can occur anywhere throughout the GI tract and are seen most commonly in the stomach (40 to 70%) and small intestine (20 to 40%) [4]. GISTs that arise outside the GI tract as primary tumor are designated as extra-GISTs (EGISTs). Due to the extremely rare incidence, data of clinicopathological features and prognosis of mesenteric gastrointestinal stromal tumors (GISTs) are limited.

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