Treatment of gastrointestinal stromal tumors: A single-center experience

North Clin Istanb. 2021 Aug 24;8(4):385-392. doi: 10.14744/nci.2020.04468. eCollection 2021.

Abstract

Objective: Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. We aimed to examine the clinical characteristics and treatment outcomes of patients diagnosed with gastrointestinal stromal tumor (GIST) who were followed up and treated in our center.

Methods: This study retrospectively evaluated the clinical characteristics, disease stages, administered treatments, and treatment responses of 67 patients diagnosed with GIST who presented to our center between 2007 and 2015.

Results: Of the 67 patients included in our study, 24 (35.8%) were female and 43 (64.2%) were male. Median age at diagnosis was 54 years (23-86). Primary tumor localization was the stomach in 38.8% (n=26), small intestine in 46.2% (n=31), colorectal in 6% (n=4), and extra-gastrointestinal in 9% (n=6) of the patients. At diagnosis, 19 patients (28.4%) were at a metastatic stage. Fifty-seven patients (85.1%) underwent surgery. Thirty-three patients received one line, 20 patients received two lines, and 12 patients received three lines of treatment. The first-line treatment resulted in complete response in 12 patients (36.4%), partial response in 15 patients (45.5%), stable disease in 5 patients (15.2%), and progression in 1 patient (3%). Progression-free survival (PFS) was 36 months for the first-line treatment. The second-line treatment resulted in partial response in 7 patients (35%), stable disease in 12 patients (60%), and progression in 1 patient (5%). PFS was 12 months for the second-line treatment. The third-line treatment resulted in complete response in 1 patient (8.3%), partial response in 3 patients (25%), stable disease in 5 patients (41.7%), and progression in 3 patients (25%). PFS was 9 months for the third-line treatment. The fourth-line treatment resulted in stable disease in 4 patients (80%) and progression in 1 patient (20%). PFS was 4 months for the fourth-line treatment. Overall survival was 90 months for all patients.

Conclusion: The use of tyrosine kinase inhibitors such as imatinib has a significant favorable effect on the prognosis in the treatment of GISTs, both in adjuvant therapy and in advanced stage disease.

Keywords: Gastrointestinal stromal tumors; imatinib; tyrosine kinase inhibitors.