Gastrointestinal stromal tumors (GISTs) and synchronous intra-abdominal malignancies: case series of a single institution’s experience
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Alexandros Diamantis1, Athina A. Samara1, Dimitrios Symeonidis1, Ioannis Baloyiannis1, Dionysia Vasdeki1, Maria Tolia2, Georgios Volakakis1, Georgios Mavrovounis1,3 and Konstantinos Tepetes1
1 Department of General Surgery, University Hospital of Larisa, Mezourlo, Larisa, Thessaly, Greece
2 Department of Radiotherapy/Radiation Oncology, Faculty of Medicine, School of Health Sciences, University of Crete, University Hospital of Heraklion, Crete, Greece
3 Faculty of Medicine, University of Thessaly, Mezourlo, Larissa, Greece
|Athina A. Samara,||email:||[email protected]|
Keywords: gastrointestinal stromal tumor; mesenchymal tumors; synchronous malignancies
Received: October 12, 2020 Accepted: December 08, 2020 Published: December 29, 2020
Background: Gastrointestinal stromal tumors (GISTs) quite often co-exist with other primary tumors, as seen in up to 33% of cases. In the literature such occurrences have primarily been described through case reports and rarely through case series, which is not sufficient to prove if there is an association between these two entities.
Materials and Methods: We conducted a retrospective study using medical and pathological records from sixty-nine patients who underwent surgical treatment for GIST in a single university surgical department between 2011 and 2019. Seven cases of GIST accompanying a synchronous primary tumor were identified and included in the study.
Results: Survival analysis comparing the overall survival of patients with single GIST versus patients with concurrent GIST and another primary tumor, has shown no statistically significant difference between these two groups (p = 0.19). However, when comparing the recurrence rate, patients with synchronous GISTs and another primary tumor have a statistically significant increased possibility for recurrence (p = 0.02). Statistical analysis comparing the size of GISTs between the two groups has shown that patients with single GIST have larger tumors than patients with synchronous tumors (p = 0.048).
Conclusions: The synchronous occurrence of GISTs and other intra-abdominal tumors is more common than previously considered, though it is not yet clear if there is a causal association for the concomitant occurrence. Further studies are required to elucidate the genetic and molecular mechanisms of carcinogenesis and progression associating GIST and synchronous tumors.
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