Clinicopathological and molecular aspects of foregut gastrointestinal stromal tumours. Issue 1 (22nd November 2012)

• Record Type: Journal Article
• Authors: Chen, Jason; Gundara, Justin S.; Haddad, Richard; Schiavone, Vivienne; Meldrum, Cliff; Samra, Jaswinder S.; Gill, Anthony J.; Hugh, Thomas J.
• Is Part Of: ANZ journal of surgery. Volume 84:Issue 1/2(2014)
• Page Start: 52
• Page End: 58
• Publication Date: 2012-11-22
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.12011
• Languages: English
• ISSNs: 1445-1433

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ans12011-sec-0001" sec-type="section"> <title>Background</title> <p>Gastrointestinal stromal tumours (GISTs) are the most common gastrointestinal mesenchymal tumour. This study describes clinicopathological and molecular characteristics in association with clinical outcome, in patients undergoing foregut GIST resection.</p> </sec> <sec id="ans12011-sec-0002" sec-type="section"> <title>Methods</title> <p>Clinicopathological data were collated retrospectively for 40 consecutive foregut GISTs. Mutational analysis (quantitative polymerase chain reaction) for <italic>KIT</italic> exons 9, 11, 13 and 17 and <italic>PDGFRa</italic> exon 18 was performed on paraffin‐embedded tissue (40 primary tumours and three metastases).</p> </sec> <sec id="ans12011-sec-0003" sec-type="section"> <title>Results</title> <p>The median age was 63 years (range: 40–92), and melaena was the most common presentation (30%). Patients undergoing a totally laparoscopic excision had the shortest mean hospital stay (5.5 days). Over a median of 72‐month follow‐up, seven patients developed recurrence/metastases. Tumour size and mitotic rate correlated with recurrence (<italic>P <</italic> 0.01; <0.01) and mortality (<italic>P</italic> = 0.03; <0.01). <italic>KIT</italic> (23/40) or <italic>PDGFRa</italic> (12/40) mutations were found in 87.5% of the primary tumours. Only patients with <italic>KIT</italic> mutations suffered mortality (<italic>n</italic> = 4; <italic>P</italic> = 0.19) and no patient with a <italic>PDGFRa</italic> developed recurrence (<italic>P</italic> = 0.13).</p> </sec> <sec id="ans12011-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Tumour site, size and mitotic rate were confirmed as prognostic markers. While <italic>KIT</italic> and <italic>PDGFRa</italic> mutations were associated with negative and positive outcomes, respectively, this did not prove to be significant. The clinical impact of these findings may only become apparent in larger series.</p> </sec> </abstract>