Gastrointestinal stromal tumors: A clinical and histopathological presentation of 27 cases
Doğan Gönüllü1 , Okan Demiray1 , Serkan İlgün1 , Ufuk Mete Yıldız1 , Mehmet Lari Gedik2 , Muzaffer Er1 ,Ayşenur İğdem3 , Elife Kimiloglu3 , Ferda N. Köksoy1
1Department of General Surgery, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
2Department of General Surgery, Ministry of Health, Fatsa State Hospital, Ordu, Turkey
3Department of Pathology, University of Health Sciences, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
Objectives: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that express type 3 tyrosine kinase receptors and are thought to develop from the neoplastic transformation of the interstitial Cajal cells. The present study was performed to morphologically and immunohistologically evaluate GISTs, to compare their qualities using a GIST risk categorization system, and to identify the diagnostic and prognostic parameters of GISTs.
Material and Methods: A total of 27 patients with GISTs underwent treatment and were followed up at the Gaziosmanpaşa Taksim Training and Research Hospital. Descriptive statistics was used to calculate the mean and median values. Survival analysis was performed by the Kaplan–Meier method. The analyses were performed using the SPSS version 22.0 software.
Results: The mean follow-up time was 3.5 (5 months to 13 years) years. The mean age was 60.4 (29–82) years. The tumors were localized in the stomach (62.9%), extraintestinal areas (14.8%), intestine (7.4%), esophagus (7.4%), and rectum (7.4%). Twenty-four patients were classified according to the Fletcher system. Of these patients, 7 (25.9%) were classified as very low risk, 8 (29.6%) as low risk, 7 (25.9%) as intermediate risk, and 2 (7.4%) as high risk. Twenty-four patients underwent surgery. Of the 3 patients who did not undergo surgery, 1 had metastatic disease at the time of diagnosis, and 2 had mini- or micro-GISTs in the stomach. On endoscopic surveillance, all tumors remained stable. Three out of the 27 patients were lost to follow-up. Two patients developed recurrence, and 1 patient died of GIST.
Conclusion: We analyzed the clinical and pathological characteristics of GIST. The most common site of tumor origin was the stomach. The size, mitotic index, and Ki-67 values were to be found high in intermediate- and high-risk groups and metastatic diseases.
Keywords: Gastrointestinal stromal tumor, interstitial Cajal cells, mesenchymal tumors, tyrosine kinase receptor mutation
This study was presented at the 36th Congress of the European Society of Surgical Oncology, 14-16 September 2016, Krakow, Poland.
Cite this paper as: Gönüllü D, Demiray O, İlgün S, Yıldız UM, Gedik ML, Er M, et al. Gastrointestinal stromal tumors: A clinical and histopathological presentation of 27 cases. Turk J Surg 2018; 34(4): 259-263.
Authors declared that the research was conducted according to the principles of the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects” (amended in October 2013).
Written informed consent was obtained from patients who participated in this study.
Concept - D.G., O.D., S.I.; Design - D.G., O.D., A.I., E.K.; Supervision - M.E., F.N.K., M.L.G.; Resource - D.G., O.D., E.K.; Materials - D.G., A.I., E.K., M.L.G.; Data Collection and/or Processing - F.N.K., S.I., M.L.G., O.D.; Analysis and/or Interpretation - D.G., F.N.K., S.I.; Literature Search D.G., O.D., F.N.K., A.İ.; Writing Manuscript - D.G., O.D., S.I.; Critical Reviews - M.E., A.İ., E.K.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.