Gastrointestinal stromal tumors: The incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era
Tóm tắt
Recent breakthroughs regarding gastrointestinal stromal tumors (GIST) and their pathogenesis have redefined diagnostic criteria and have led to the development of molecularly targeted drug therapy. New treatment options mandate more accurate information regarding the incidence, prevalence, clinical behavior, and prognostic factors of GIST.
All patients (
Ninety percent of GISTs were detected clinically due to symptoms (69%) or were incidental findings at surgery (21%); the remaining 10% of GISTs were found at autopsy. Forty‐four percent of symptomatic, clinically detected GISTs were categorized as high risk (29%) or overtly malignant (15%), with tumor‐related deaths occurring in 63% of patients and 83% of patients, respectively (estimated median survival, of 40 months and 16 months, respectively). Tumor‐related deaths occurred in only 2 of 170 of patients (1.2%) with very‐low‐risk, low‐risk, or intermediate‐risk tumors. The annual incidence of GIST was 14.5 per million. The prevalence of all GIST risk groups was 129 per million (31 per million for the high‐risk group and the overtly malignant group).
GIST has been under recognized: Its incidence, prevalence, and clinical aggressiveness also have been underestimated. Currently existing risk‐group stratification systems based on tumor size and mitotic rate delineate GIST patients who have a poor prognosis. Prognostication in patients with GIST can be refined using a proposed risk score based solely on tumor size and proliferative index. Cancer 2005. © 2005 American Cancer Society.
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Tài liệu tham khảo
Kindblom LG, 1998, Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal, Am J Pathol., 152, 1259
Rubin BP, 2001, KIT activation is a ubiquitous feature of gastrointestinal stromal tumors, Cancer Res., 61, 8118
Breslow NE, 1987, 131
Suster S, 1996, Gastrointestinal stromal tumors, Semin Diagn Pathol., 13, 297
Emory TS, 1997, Ki‐67 (MIB‐1) immunohistochemistry as a prognostic factor in gastrointestinal smooth‐muscle tumors, J Surg Pathol., 239