Abstract
Background and Objectives: In this study, we investigated the frequency and type of second primary malignant tumors (SPMTs) accompanying gastrointestinal stromal tumors (GISTs), patient and tumor characteristics, and follow-up and survival data. Materials and Methods: We included 20 patients with SPMTs from a total of 103 patients with GISTs in a single center in Turkey. At the time of GIST diagnosis, patient age, sex, presentation symptoms, localization, pathological features of the tumor, stage, recurrence risk scoring for localized disease, treatments received, time of SPMT association, follow-up times, and survival analysis were recorded for each patient. Localization, histopathology, and stage of SPMT accompanying GISTs were also recorded accordingly. Results: SPMT was detected in 19.4% of patients with GISTs. Of the patients, 50% were men and 50% were women. The mean age at the time of diagnosis of GIST was 63.8 ± 10.81 years (range: 39–77 years). Of the GISTs, 60% were localized in the stomach, 25% in the small intestine, and 70% were at low risk. Of the SPMTs, 60% were in the gastrointestinal system. SPMTs were diagnosed as synchronous with GISTs in 50% of the patients. The mean follow-up period of the patients from the diagnosis of GIST was 45.6 (0.43–129.6) months. When the data were finalized, 5% died due to GIST, 35% died due to SPMT, and 15% died due to non-disease-related causes. Conclusions: SPMT was detected in 19.4% of patients with GISTs. GISTs were frequently located in the stomach, and most of them were at low risk. The most common SPMTs were gastrointestinal system tumors, and their coexistence was found to be synchronous. Most patients died due to SPMT during follow-up.
Highlights
When previously reported data and the results of our study are combined, we find that the coexistence of gastrointestinal stromal tumors (GISTs) and second primary malignant tumors (SPMTs) generally determines secondary tumor survival
We found that the incidence of GIST and SPMT was 19.4%
GISTs are frequently located in the stomach and are mostly at a low risk
Summary
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal system They are rare, constituting 1% of all sarcomas and 3–5% of gastrointestinal tumors [1], and their incidence has been reported to be 10–15 per million in most studies [2]. They frequently originate from the stomach (60–70%) and small intestine (25–35%), and less frequently from the colon, rectum, and appendix (5% altogether), and the esophagus (2–3%). The use of imatinib as a neoadjuvant before surgery and as an adjuvant in patients at high risk after the operation and at the unresectable/metastatic stage, increases the response and survival rates [6,7,8]. Second primary tumor development may occur in patients, in addition to GISTs, with increasing life expectancy
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