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Synchronous occurrence of gastrointestinal stromal tumors and other digestive tract malignancies in the elderly.

Shen C, Chen H, Yin Y, Chen J, Han L, Zhang B, Chen Z, Chen J - Oncotarget (2015)

Bottom Line: A total of 161 patients (≥65 years) were retrospectively reviewed at the West China Hospital, Sichuan University from January 2009 to June 2014.The synchronous group exhibited a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer Eastern Cooperative Oncology Group performance status than the no-synchronous group (P = 0.029).The three-year overall survival (OS) rate was significantly lower among patients with synchronous digestive tract malignancies than that among patients without synchronous condition (64.5% vs. 84.0%, P = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.

ABSTRACT

Background/aims: Elderly patients with gastrointestinal stromal tumors (GISTs) synchronous with other digestive tract malignancies have been rarely reported. In this study, clinicopathological characteristics were evaluated among elderly patients with GISTs with or without coexisting digestive tract malignancies.

Methods: A total of 161 patients (≥65 years) were retrospectively reviewed at the West China Hospital, Sichuan University from January 2009 to June 2014.

Results: Sixty-one patients were diagnosed with synchronous digestive tract malignancies (synchronous group), whereas 100 patients were diagnosed with no synchronous condition (no-synchronous group). The synchronous group exhibited a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer Eastern Cooperative Oncology Group performance status than the no-synchronous group (P = 0.029). The three-year overall survival (OS) rate was significantly lower among patients with synchronous digestive tract malignancies than that among patients without synchronous condition (64.5% vs. 84.0%, P = 0.003). Multivariate analysis showed that the presence of synchronous digestive tract malignancies (P = 0.002), co-morbidity (P = 0.004), and mitotic count ≥10 mitoses/50 high power fields (P = 0.012) were associated with poor OS.

Conclusions: A synchronous condition with other digestive tract malignancies is common in elderly patients with GISTs. OS primarily depends on synchronous digestive tract malignancies, mitotic count, and co-morbidity.

No MeSH data available.


Related in: MedlinePlus

Preoperative abdominal enhanced CT scan showed a mass (white arrow in A) with a size of 3.5cm×3 cm located in the abdominal cavity in one patient with rectal cancerUpper gastrointestinal endoscopy presented an intramural lesion (B) located in the body of the patient with GIST of the stomach synchronous with a small carcinelcosis located in the antrum of the stomach. Tumor complete resection was obtained through the endoscopic view (C) Image of the tumor resected through endoscopic resection; the tumor size was lower than 2 cm (D).
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Figure 1: Preoperative abdominal enhanced CT scan showed a mass (white arrow in A) with a size of 3.5cm×3 cm located in the abdominal cavity in one patient with rectal cancerUpper gastrointestinal endoscopy presented an intramural lesion (B) located in the body of the patient with GIST of the stomach synchronous with a small carcinelcosis located in the antrum of the stomach. Tumor complete resection was obtained through the endoscopic view (C) Image of the tumor resected through endoscopic resection; the tumor size was lower than 2 cm (D).

Mentions: The entire cohort comprised 161 elderly patients with GISTs and included 96 (59.6%) males and 65 (40.4%) females with a mean age of 69.93±4.37 years and a median age of 69 years (range, 65–84 years). Of these 161 enrolled patients, 61 were diagnosed with GISTs synchronous with other digestive tract malignancies (synchronous group), whereas 100 were diagnosed with no-synchronous condition (no-synchronous group). The most common localization site of GISTs was the stomach (n = 134, 83.2%), followed by the small intestine (n = 17, 10.6%) and other parts of the system (n = 10, 6.2%; including mesentery of small intestine, omentum, rectum, and transverse mesentery). A high number of GISTs located in the stomach were observed in the synchronous group (P = 0.005). The synchronous group also presented a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer ECOG performance status (P = 0.029) than the no-synchronous group. Moreover, no statistical significance was detected with regard to age, co-morbidity, and hospital stay between the groups (P > 0.05). In the no-synchronous group, patients with GISTs variably presented abdominal discomfort/pain (n = 43), gastrointestinal bleeding (n = 36), and mass (n = 11), which were incidentally discovered for other reasons (n = 10). In the synchronous group, all but three patients (one case was preoperatively discovered through CT and two cases through electronic endoscopy; Figure 1AB) with GISTs were incidentally detected during surgery or postoperative pathologic examination. Data are shown in Table 1.


Synchronous occurrence of gastrointestinal stromal tumors and other digestive tract malignancies in the elderly.

Shen C, Chen H, Yin Y, Chen J, Han L, Zhang B, Chen Z, Chen J - Oncotarget (2015)

Preoperative abdominal enhanced CT scan showed a mass (white arrow in A) with a size of 3.5cm×3 cm located in the abdominal cavity in one patient with rectal cancerUpper gastrointestinal endoscopy presented an intramural lesion (B) located in the body of the patient with GIST of the stomach synchronous with a small carcinelcosis located in the antrum of the stomach. Tumor complete resection was obtained through the endoscopic view (C) Image of the tumor resected through endoscopic resection; the tumor size was lower than 2 cm (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4480761&req=5

Figure 1: Preoperative abdominal enhanced CT scan showed a mass (white arrow in A) with a size of 3.5cm×3 cm located in the abdominal cavity in one patient with rectal cancerUpper gastrointestinal endoscopy presented an intramural lesion (B) located in the body of the patient with GIST of the stomach synchronous with a small carcinelcosis located in the antrum of the stomach. Tumor complete resection was obtained through the endoscopic view (C) Image of the tumor resected through endoscopic resection; the tumor size was lower than 2 cm (D).
Mentions: The entire cohort comprised 161 elderly patients with GISTs and included 96 (59.6%) males and 65 (40.4%) females with a mean age of 69.93±4.37 years and a median age of 69 years (range, 65–84 years). Of these 161 enrolled patients, 61 were diagnosed with GISTs synchronous with other digestive tract malignancies (synchronous group), whereas 100 were diagnosed with no-synchronous condition (no-synchronous group). The most common localization site of GISTs was the stomach (n = 134, 83.2%), followed by the small intestine (n = 17, 10.6%) and other parts of the system (n = 10, 6.2%; including mesentery of small intestine, omentum, rectum, and transverse mesentery). A high number of GISTs located in the stomach were observed in the synchronous group (P = 0.005). The synchronous group also presented a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer ECOG performance status (P = 0.029) than the no-synchronous group. Moreover, no statistical significance was detected with regard to age, co-morbidity, and hospital stay between the groups (P > 0.05). In the no-synchronous group, patients with GISTs variably presented abdominal discomfort/pain (n = 43), gastrointestinal bleeding (n = 36), and mass (n = 11), which were incidentally discovered for other reasons (n = 10). In the synchronous group, all but three patients (one case was preoperatively discovered through CT and two cases through electronic endoscopy; Figure 1AB) with GISTs were incidentally detected during surgery or postoperative pathologic examination. Data are shown in Table 1.

Bottom Line: A total of 161 patients (≥65 years) were retrospectively reviewed at the West China Hospital, Sichuan University from January 2009 to June 2014.The synchronous group exhibited a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer Eastern Cooperative Oncology Group performance status than the no-synchronous group (P = 0.029).The three-year overall survival (OS) rate was significantly lower among patients with synchronous digestive tract malignancies than that among patients without synchronous condition (64.5% vs. 84.0%, P = 0.003).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.

ABSTRACT

Background/aims: Elderly patients with gastrointestinal stromal tumors (GISTs) synchronous with other digestive tract malignancies have been rarely reported. In this study, clinicopathological characteristics were evaluated among elderly patients with GISTs with or without coexisting digestive tract malignancies.

Methods: A total of 161 patients (≥65 years) were retrospectively reviewed at the West China Hospital, Sichuan University from January 2009 to June 2014.

Results: Sixty-one patients were diagnosed with synchronous digestive tract malignancies (synchronous group), whereas 100 patients were diagnosed with no synchronous condition (no-synchronous group). The synchronous group exhibited a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer Eastern Cooperative Oncology Group performance status than the no-synchronous group (P = 0.029). The three-year overall survival (OS) rate was significantly lower among patients with synchronous digestive tract malignancies than that among patients without synchronous condition (64.5% vs. 84.0%, P = 0.003). Multivariate analysis showed that the presence of synchronous digestive tract malignancies (P = 0.002), co-morbidity (P = 0.004), and mitotic count ≥10 mitoses/50 high power fields (P = 0.012) were associated with poor OS.

Conclusions: A synchronous condition with other digestive tract malignancies is common in elderly patients with GISTs. OS primarily depends on synchronous digestive tract malignancies, mitotic count, and co-morbidity.

No MeSH data available.


Related in: MedlinePlus