gastrointestinal stromal tumors: epidemiology and treatment outcomes

introduction: numerous studies have investigated the prevalence, incidence and clinical manifestations of gastrointestinal stromal tumors (gists). however, little is known about gists in iran. this pioneer study focuses on description of 36 patients with gists in iran. methods: a database was created for 36 patients suffering from gist who were treated in loghman medical center and tehran cancer institute in tehran, iran. information on age, sex, clinical manifestations, treatment and outcomes were recorded and analyzed using spss version 13. results: patients had an average age of 60 years; and 16 of them were males. the disease was most commonly manifested by abdominal mass, weight loss, and anemia. twenty one patients had a mass smaller than 10cm; and in 33 patients kit test was positive. in the follow-up, 5 patients experienced relapse and 3 succumbed due to advanced cancer. conclusion: primary results showed that gists might have different manifestations and incidence in iran compared to other parts of the world. we hope that this study could serve as a starting point for the better understanding and classification of this disease in iran and for development of improved management strategies. keywords: gastrointestinal stromal tumors (gist); 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243:738–745; discussion 745-7. 21-  buchdunger e, cioffi cl, law n, et al. abl protein-tyrosine kinase inhibitor sti571 inhibits in vitro signal transduction mediated by c-kit and platelet-derived growth factor receptors. j pharmacol exp ther 2000; 295:139-45. 22-  joensuu h, fletcher c, dimitrijevic s, et al. management of malignant gastrointestinal stromal tumours. lancet oncol 2002; 3:655-64. 23-  corless cl, schroeder a, griffith d, et al. pdgfra mutations in gastrointestinal stromal tumors: frequency, spectrum and in vitro sensitivity to imatinib. j clin oncol 2005; 23:5357-64. 24-  demetri gd, benjamin rs, blanke cd, et al. nccn task force report: management of patients with gastrointestinal stromal tumor (gist)dupdate of the nccn clinical practice guidelines. j natl compr canc netw 2007; 5(suppl 2):1-29. 25-  blay jy, bonvalot s, casali p, et al. consensus meeting for the management of gastrointestinal stromal tumors. report of the gist consensus conference of march 20–21, 2004. ann oncol 2005; 16:566-78. 26-  mendel db, laird ad, xin x, et al. in vivo antitumor activity of su11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: determination of a pharmacokinetic/ pharmacodynamic relationship. clin cancer res 2003; 9: 327-37. 27-  desai j, dileo p,morgan ja, et al.hypothyroidism may accompany su11248 therapy in a subset of patients (pts) with metastatic (met) gastrointestinal stromal tumors (gist) and is manageable with replacement therapy. 2005 asco annual meeting. j clin oncol 2005 asco annual meeting proceedings 2005; 23(16s pt i june 1 suppl):3040. andtbacka rh, ng cs, scaife cl, et al. surgical resection of gastrointestinal stromal tumors after treatment with imatinib. ann surg oncol 2007; 14(1):14-24.   1-         connolly em, gaffney e, reynolds jv.gastrointestinal stromal     tumours. br j surg 2003; 90:1178-86. 2-         mazur mt, clark hb. gastric stromal tumors. reappraisal of histogenesis. am j surg pathol 1983; 7:507-59. 3-         nilsson b, bumming p, meis-kindblom jm, et al. gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era—a population-based study in western sweden. cancer 2005; 103:821-9. 4-         hirota s, isozaki k, moriyama y, hashimoto k, et al. gain of function mutations of c-kit in human gastrointestinal stromal tumors. science 1998; 279: 577-80 5-         miettinen m, sarlomo-rikala m, lasota j, et al. gastrointestinal stromal tumors: recent advances in understanding of their biology. hum. path. 1999; 30: 1213-20. 6-         miettinen, m, lasota, j. gastrointestinal stromal tumors(gist):definition, occurrence, pathology, differential diagnosis and molecular genetics. pol j pathol 2003;54:3-24 7-         fletcher cd, berman jj, corless c, et al. diagnosis of gastrointestinal stromal tumors: a consensus approach. hum pathol 2002; 33:459-65. 8-         michael c. heinrich, christopher l. corless, et al. molecular correlates of imatinib resistance in gastrointestinal stromal tumors, j. clinical oncology 2006;24 (29): 4764-74 9-         tran t, davila ja, el-serag hb. the epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. am j gastroenterol 2005; 100:162-8. 10-     chou ff, eng hl, sheen-chen sm. smooth muscle tumors of the gastrointestinal tract: analysis of prognostic factors. surgery 1996; 119:171-7. 11-     n yaramov, g velev, g todorov, ts lukanova, et al: [gastrointestinal stromal tumors (gist) - clinical experience and current therapeutical aspects.]. khirurgiia (sofiia). 2007; 62(4): 27-32.   12-           liberati g, lucchetta mc, petraccia l, nocchi s, et al. meta-analytical study of gastrointestinal stromal tumors. clin ter 2003; 154(2): 85-91 13-     bucher p, taylor s, villiger p, morel p, et al. are there any prognostic factors for small intestinal stromal tumors?. am j surg 2004; 187: 761-6 14-     efron dt, lillemoe kd. the current management of gastrointestinal stromal tumors. adv surg 2005; 39:193-2     0     1. 15-     dematteo rp, lewis jj, leung d, et al. two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. ann surg 2000; 231(1):51     -   8. 16-   corless cl, fletcher ja, heinrich mc. biology of gastrointestinal stromal tumors. j clin oncol 2004;22(18):3813 - 25. 17-   matthews bd, joels cs, kercher kw, heniford bt. gastrointestinal stromal tumors of stomach. minerva chir 2004; 59:219-31. 18-   demetri gd, benjamin rs, blanke cd, et al. nccn task force report: management of patients with gastrointestinal stromal tumor (gist)dupdate of the nccn clinical practice guidelines. j natl compr canc netw 2007; 5(suppl 2):1-29. 19-   iwahashi m, takifuji k, ojima t, et al. surgical management of small gastrointestinal stromal tumors of the stomach. world j surg 2006; 30:28-35. 20-   novitsky yw, kercher kw, sing rf, heniford bt. long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. ann surg 2006; 243:738–745; discussion 745-7. 21-   buchdunger e, cioffi cl, law n, et al. abl protein-tyrosine kinase inhibitor sti571 inhibits in vitro signal transduction mediated by c-kit and platelet-derived growth factor receptors. j pharmacol exp ther 2000; 295:139 - 45. 22-   joensuu h, fletcher c, dimitrijevic s, et al. management of malignant gastrointestinal stromal tumours. lancet oncol 2002; 3:655-64. 23-   corless cl, schroeder a, griffith d, et al. pdgfra mutations in gastrointestinal stromal tumors: frequency, spectrum and in vitro sensitivity to imatinib. j clin oncol 2005; 23:5357-64. 24-   demetri gd, benjamin rs, blanke cd, et al. nccn task force report: management of patients with gastrointestinal stromal tumor (gist)dupdate of the nccn clinical practice guidelines. j natl compr canc netw 2007; 5(suppl 2):1-29. 25-   blay jy, bonvalot s, casali p, et al. consensus meeting for the management of gastrointestinal stromal tumors. report of the gist consensus conference of march 20–21, 2004. ann oncol 2005; 16:566 - 78. 26-   mendel db, laird ad, xin x, et al. in vivo antitumor activity of su11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and platelet-derived growth factor receptors: determination of a pharmacokinetic/ pharmacodynamic relationship. clin cancer res 2003; 9: 327-37. 27-   desai j, dileo p,morgan ja, et al.hypothyroidism may accompany su11248 therapy in a subset of patients (pts) with metastatic (met) gastrointestinal stromal tumors (gist) and is manageable with replacement therapy. 2005 asco annual meeting. j clin oncol 2005 asco annual meeting proceedings 2005; 23(16s pt i june 1 suppl):3040. andtbacka rh, ng cs, scaife cl, et al. surgical resection of gastrointestinal stromal tumors after treatment with imatinib. ann surg oncol 2007; 14(1):14 - 24.