versión On-line ISSN 2078-5151
versión impresa ISSN 0038-2361
S. Afr. j. surg. vol.49 no.3 Cape Town ago. 2011
R. J. HartleyI; J. H. R. BeckerII; H. van der WaltI; T. LuvhengoI
IM.B. Ch.B., M.Med. (chir.), F.C.S. (s.A.); Department of General Surgery, Faculty of Health Sciences, University of Pretoria
IIM.B. Ch.B., M.Med. (chir.), F.C.S. (s.A.), F.R.C.S. (glasg.), F.R.C.S. (edin.); Department of General Surgery, Faculty of Health Sciences, University of Pretoria
AIM: To analyse the presentation and management of patients with gastro-intestinal stromal tumours (GISTs) at Pretoria hospitals.
DESIGN: A retrospective study was done in which all available clinical records of primary c-KIT positive GISTs were analysed.
SETTING: Secondary and tertiary care institutions in Pretoria, including both private and public hospitals.
SUBJECTS: The population studied included all individuals treated at Pretoria hospitals from 17 July 2000 to 1 April 2009 who had a GIST confirmed with immunohistochemical c-KIT staining. Patients with incomplete or inaccessible clinical records were excluded.
OUTCOME MEASURES: Patient demographics including gender, age and race; presenting symptoms and signs; results of special investigations; and treatment.
RESULTS: Fifty-four cases were identified for inclusion in the study. The age of the subjects ranged from 15 to 83 years. The male-to-female ratio was 1.5:1. The organ most commonly affected was the stomach, and abdominal pain and weight loss were the most common presenting symptoms. Seventy-six per cent of the patients were treated surgically, and 24% received imatinib.
CONCLUSION: GISTs often present late with nonspecific symptoms, and are frequently discovered incidentally. Large tumours tend to be malignant.
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1. Gupta P, Tewari M, Shukla HS. Gastrointestinal stromal tumour. Surg Oncol 2008;17(2):129-138. [ Links ]
2. Blum MG, Bilimoria KY, Wayne JD, et al. Surgical consideration for the management and resection of esophageal gastrointestinal stromal tumours. Ann Thorac Surg 2007;84:1717-1723. [ Links ]
3. Samelis GF, Ekmektzoglou KA, Zografos GC. Gastrointestinal stromal tumours: Clinical overview, surgery and recent advances in Imatinib mesylate therapy. Eur J Surg Oncol 2007;33:942-950. [ Links ]
4. Hopkins TG, Marples M, Stark, D. Sunitinib in the management of gastrointestinal stromal tumours. Eur J Surg Oncol 2008;34(8):844-850. [ Links ]
5. Madeiros F, Corless CL, Duensing A, et al. KIT-negative gastrointestinal stromal tumors. Am J Surg Pathol 2004;28(7):889-894. [ Links ]
6. Somerhaus N de Saint Aubain, Fletcher CDM. Gastrointestinal stromal tumours: an update. Sarcoma 1998;2:133-141. [ Links ]
7. Rader AE, Avery A, Wait CL, et al. Fine-needle aspiration biopsy diagnosis of gastrointestinal stromal tumours using morphology, immunocytochemistry, and mutational analysis of c-kit. Cancer 2001;93(4):269-275. [ Links ]
8. Stamatakos M, Douzinas E, Stefanaki C, et al. Gastrointestinal stromal tumour. World J Surg Oncol 2009;7:61. Published online 1 August 2009. doi: 10.1186/1477-7819-7-61. [ Links ]
9. DeMatteo R, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumours recurrence patterns and prognostic factors for survival. Ann Surg 2000;231(1):51. [ Links ]
10. Miettinen M, Majidi M, Lasota J. Pathology and diagnostic criteria of gastrointestinal stromal tumours: a review. Eur J Cancer 2002;38:39-51. [ Links ]
11. Mukherjee S, Sawyer MAJ, Decker RA. Gastrointestinal stromal tumours. Med-scape Reference. http://emedicine.medscape.com/article/179669-overview (accessed 4 February 2010). [ Links ]
12. Coffey RJ, Washington MK, Corless CL, et al. Menetrier disease and gastrointestinal stromal tumours: hyperproliferative disorders of the stomach. J Clin Invest 2007;117(1):70-80. [ Links ]
13. Davis AR, Ahmed W, Purkiss SF. Port site metastasis following diagnostic laparoscopy for a malignant gastro-intestinal stromal tumour. World J Surg Oncol 2008;6:55. [ Links ]
14. Van Glabbeke M, Verweij J, Casali PG, et al. Initial and late resistance to Imatinib in advanced gastrointestinal stromal tumours are predicted by different prognostic factors: A European Organisation for Research and Treatment of Cancer-Italian Sarcoma Group-Australian Gastrointestinal Trails Group Study. J Clin Oncol 2005;23:5795-5804. [ Links ]
15. Demetri GD, Von Mehren M, Blake CD, et al. Efficacy and safety of Imatinib mesylate in advanced gastrointestinal stromal tumours. New Engl J Med 2002;347:472-480. [ Links ]