Epidemiology of Gastrointestinal Stromal Tumors in the Era of Histology Codes: Results of a Population-Based Study
Tóm tắt
To date, all population-based epidemiologic data on gastrointestinal stromal tumor (GIST) in the United States predate the 2001 implementation of GIST-specific histology coding. As such, results from previous studies were limited because of inclusion of non-GIST abdominal or gastrointestinal sarcomas. We used a national cancer registry with modern day histologic codes to gain greater insight into the true epidemiology of GIST in the United States. We identified 6,142 patients diagnosed with GIST between 2001 and 2011 in the Surveillance, Epidemiology, and End Results database. Incidence, survival, demographic risk factors, and prognostic factors were analyzed. Annual age-adjusted incidence rose from 0.55/100,000 in 2001 to 0.78/100,000 in 2011 and increased with age, peaking among 70- to 79-year-olds (3.06/100,000). GIST was also more common in males than females [rate ratio (RR), 1.35], non-Hispanics than Hispanics (RR, 1.23), and blacks (RR, 2.07) or Asians/Pacific Islanders (RR, 1.50) than whites. The study period had 5-year overall and GIST-specific survival rates of 65% and 79%, respectively. The 5-year overall survival rates for those with localized, regional, and metastatic disease at diagnosis were 77%, 64%, and 41%, respectively. Multivariate analyses demonstrated that older age at diagnosis, male sex, black race, and advanced stage at diagnosis were independent risk factors for worse overall survival. Multivariate analysis also showed the four aforementioned characteristics, along with earlier year of diagnosis, to be independent risk factors for worse GIST-specific survival. As the first population-based, epidemiologic study of histologically confirmed disease, our findings provide a robust representation of GIST in the era of immunohistochemical diagnoses. Cancer Epidemiol Biomarkers Prev; 24(1); 298–302. ©2014 AACR.
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Tài liệu tham khảo
Perez, 2006, Current incidence and outcomes of gastrointestinal mesenchymal tumors including gastrointestinal stromal tumors, J Am Coll Surg, 202, 623, 10.1016/j.jamcollsurg.2006.01.002
Miettinen, 2001, Gastrointestinal stromal tumors–definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis, Virchows Arch, 438, 1, 10.1007/s004280000338
Fletcher, 2002, Diagnosis of gastrointestinal stromal tumors: A consensus approach, Hum Pathol, 33, 459, 10.1053/hupa.2002.123545
Tran, 2005, The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000, Am J Gastroenterol, 100, 162, 10.1111/j.1572-0241.2005.40709.x
Blanke, 2005, Epidemiology of GIST, Am J Gastroenterol, 100, 2366, 10.1111/j.1572-0241.2005.50650_6.x
Cheung, 2009, Disappearance of racial disparities in gastrointestinal stromal tumor outcomes, J Am Coll Surg, 209, 7, 10.1016/j.jamcollsurg.2009.03.018
Rubin, 2011, Epidemiology, survival, and costs of localized gastrointestinal stromal tumors, Int J Gen Medicine, 4, 121
Hirota, 1998, Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors, Science, 279, 577, 10.1126/science.279.5350.577
Surveillance, Epidemiology, and End Results (SEER), Program (
Day, 1996, Population Projections of the United States by Age, Sex, Race, and Hispanic Origin: 1995 to 2050. US Bureau of the Census, Current Population Reports, P25–1130
Tiwari, 2006, Efficient interval estimation for age-adjusted cancer rates, Stat Methods Med Res, 15, 547, 10.1177/0962280206070621
Chiang, 2014, The epidemiology of gastrointestinal stromal tumors in Taiwan, 1998–2008: a nation-wide cancer registry-based study, BMC Cancer, 14, 102, 10.1186/1471-2407-14-102
Edge, 2010, The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM, Ann Surg Oncol, 17, 1471, 10.1245/s10434-010-0985-4
DeMatteo, 2000, Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival, Ann Surg, 231, 51, 10.1097/00000658-200001000-00008
Hassan, 2008, Surgically managed gastrointestinal stromal tumors: a comparative and prognostic analysis, Ann Surg Oncol, 15, 52, 10.1245/s10434-007-9633-z