Clinical Response Variables in Patients with Advanced-Stage Gastrointestinal Stromal Sarcoma

Abstract

Introduction: Gastrointestinal stromal tumors are rare tumors and they constitute 0.2% of all tumors that occur in the gastrointestinal tract. In most patients, disease control is achieved with surgery and a tyrosine kinase inhibitor (imatinib).

Objective: To identify the variables of a poor prognosis associated with the progression of gastrointestinal stromal sarcoma.

Methods: A retrospective and observational study was carried out in patients with advanced gastrointestinal stromal sarcoma disease at Hermanos Ameijeiras Clinical Surgical Hospital in the period from January 2003 to December 2020. Summary measures were used for qualitative variables, absolute and relative frequencies expressed in percentages; and the chi-square test to evaluate the association between the variables.

Results: A total of 219 patients were studied with mean age of 57.6 years and 52.5% were male. Forty-five percent of patients had extragastric tumors predominantly in the small intestine, which debuted in metastatic disease and frequently in the peritoneum (54%). In a Cox regression study, the lowest survival was significantly related to Ki-67 greater than 5% as well as unresectable tumors, tumor rupture and the presence of metastatic disease (p = 0.001).

Conclusions: The patients were mostly elderly men with extragastric disease. Poor prognostic factors were identified as tumors larger than 10 cm, high KI-67, unresectable tumors, tumor rupture and the presence of metastasis at diagnosis.