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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

Kaplan–Meier estimates of the OS of 161 elderly patients with GISTs(A) OS was significantly lower in patients with synchronous digestive malignancies than that without these diseases (P = 0.003). (B) Stratification based on the types of synchronous digestive tract malignancies; the three-year OS rate of patients in the no-synchronous group was higher than that of patients with GISTs synchronous with EC (P = 0.005) and with GC (P = 0.021). GC refers to gastric cancer, and EC refers to esophageal cancer.
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Figure 2: Kaplan–Meier estimates of the OS of 161 elderly patients with GISTs(A) OS was significantly lower in patients with synchronous digestive malignancies than that without these diseases (P = 0.003). (B) Stratification based on the types of synchronous digestive tract malignancies; the three-year OS rate of patients in the no-synchronous group was higher than that of patients with GISTs synchronous with EC (P = 0.005) and with GC (P = 0.021). GC refers to gastric cancer, and EC refers to esophageal cancer.

Mentions: Thirty-one patients died for the entire cohort with a median follow-up of 21 months (range, 3–70 months). Twenty-six patients presented GIST-specific progression in the no-synchronous group. The one-, two-, and three-year progression-free survival rates in the no-synchronous group were 90.5%, 82.1%, and 66.7%, respectively. The three-year OS rate was significantly lower among patients with synchronous digestive tract malignancies than that of patients without synchronous disease (64.5% vs. 84.0%, P = 0.003; Figure 2A). The median survival was not achieved for patients with GISTs only (three-year OS was 84.0%) versus 24 months for patients with GISTs synchronous with esophageal cancer (three-year OS was 62.6%) and 19 months for patients with GISTs synchronous with gastric cancer (three-year OS was 68.7%). The three-year OS rate of patients in the no-synchronous group was higher than that of patients with GISTs synchronous with esophageal carcinoma (P = 0.005) and with gastric carcinoma (P = 0.021, Figure 2B). The OS of low-, intermediate-, and high-risk GISTs in the no-synchronous group were 94.1%, 89.2%, and 75.1% at three years, respectively, and no patient with very low risk died. Accordingly, OS of very low-risk GISTs in the synchronous group was 70.5% at three years. Two patients for both low and intermediate risk died, and one patient with high risk died 35 months in the synchronous group postoperatively. The univariate and multivariate analyses of factors affecting the OS of elderly patients with GISTs are summarized in Table 3. The presence of synchronous digestive tract malignancies and co-morbidity was associated with poorer OS rate in the univariate analysis (P < 0.05). Moreover, multivariate analysis showed that synchronous digestive tract malignancies (P = 0.002), mitotic count (P = 0.012), and co-morbidity (P = 0.004) were independent predictors of OS.


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)

Kaplan–Meier estimates of the OS of 161 elderly patients with GISTs(A) OS was significantly lower in patients with synchronous digestive malignancies than that without these diseases (P = 0.003). (B) Stratification based on the types of synchronous digestive tract malignancies; the three-year OS rate of patients in the no-synchronous group was higher than that of patients with GISTs synchronous with EC (P = 0.005) and with GC (P = 0.021). GC refers to gastric cancer, and EC refers to esophageal cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Kaplan–Meier estimates of the OS of 161 elderly patients with GISTs(A) OS was significantly lower in patients with synchronous digestive malignancies than that without these diseases (P = 0.003). (B) Stratification based on the types of synchronous digestive tract malignancies; the three-year OS rate of patients in the no-synchronous group was higher than that of patients with GISTs synchronous with EC (P = 0.005) and with GC (P = 0.021). GC refers to gastric cancer, and EC refers to esophageal cancer.
Mentions: Thirty-one patients died for the entire cohort with a median follow-up of 21 months (range, 3–70 months). Twenty-six patients presented GIST-specific progression in the no-synchronous group. The one-, two-, and three-year progression-free survival rates in the no-synchronous group were 90.5%, 82.1%, and 66.7%, respectively. The three-year OS rate was significantly lower among patients with synchronous digestive tract malignancies than that of patients without synchronous disease (64.5% vs. 84.0%, P = 0.003; Figure 2A). The median survival was not achieved for patients with GISTs only (three-year OS was 84.0%) versus 24 months for patients with GISTs synchronous with esophageal cancer (three-year OS was 62.6%) and 19 months for patients with GISTs synchronous with gastric cancer (three-year OS was 68.7%). The three-year OS rate of patients in the no-synchronous group was higher than that of patients with GISTs synchronous with esophageal carcinoma (P = 0.005) and with gastric carcinoma (P = 0.021, Figure 2B). The OS of low-, intermediate-, and high-risk GISTs in the no-synchronous group were 94.1%, 89.2%, and 75.1% at three years, respectively, and no patient with very low risk died. Accordingly, OS of very low-risk GISTs in the synchronous group was 70.5% at three years. Two patients for both low and intermediate risk died, and one patient with high risk died 35 months in the synchronous group postoperatively. The univariate and multivariate analyses of factors affecting the OS of elderly patients with GISTs are summarized in Table 3. The presence of synchronous digestive tract malignancies and co-morbidity was associated with poorer OS rate in the univariate analysis (P < 0.05). Moreover, multivariate analysis showed that synchronous digestive tract malignancies (P = 0.002), mitotic count (P = 0.012), and co-morbidity (P = 0.004) were independent predictors of OS.

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