Abstract
BackgroundRecently developed immunohistochemical markers have revolutionised the classification of gastrointestinal stromal tumours (GISTs) whilst tyrosine kinase inhibitors (imatinib) have had a significant impact on the treatment of advanced tumours. We review the clinicopathological features of previously resected mesenchymal tumours of the gastrointestinal tract in our institution to 1) reclassify the histological diagnosis of those stained prior to c-kit availability; 2) perform survival analysis to identify prognostic factors, and 3) to consider the implications for patients.MethodsClinicopathological records of patients with a diagnosis of mesenchymal tumours treated between May 1992 and April 2007 were reviewed.Results82 patients were reviewed. 26 (32%) were reclassified as GISTs following c-kit immunostaining and a further 14 patients were treated for GIST up to April 2007 (Total: 40 patients; 21 males and 19 females, mean age 67, range 30-92 years). 36 (90%) underwent complete resection. 5-year survival of patients with GIST alone was 80%. Females had a better median survival (M: F 43 months: 73 months).ConclusionsThe availability of c-kit staining allowed 32% of previously diagnosed mesenchymal tumours to be reclassified as GISTs. This may have implications for the follow-up of patients diagnosed prior to the availability of this method.
Highlights
Gastrointestinal stromal tumours (GISTs) are the most common form of mesenchymal tumours of the GI tract
82 specimens previously classified as mesenchymal tumours of the GI tract between May 1992 and July 2003 were reviewed histologically of which 26 (32%) were reclassified as GIST following c-kit immunostaining
Our study shows that approximately 1/3 of previously diagnosed mesenchymal tumours of the gastrointestinal tract could be reclassified as GISTs
Summary
Gastrointestinal stromal tumours (GISTs) are the most common form of mesenchymal (connective tissue) tumours of the GI tract. They are rare and represent approximately 0.3-3% of all gastrointestinal tumours [1]. Detection of the c-kit protein in tumour cells by immunohistochemistry is the standard criterion for the diagnosis of GIST. Developed immunohistochemical markers have revolutionised the classification of gastrointestinal stromal tumours (GISTs) whilst tyrosine kinase inhibitors (imatinib) have had a significant impact on the treatment of advanced tumours. We review the clinicopathological features of previously resected mesenchymal tumours of the gastrointestinal tract in our institution to 1) reclassify the histological diagnosis of those stained prior to c-kit availability; 2) perform survival analysis to identify prognostic factors, and 3) to consider the implications for patients
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