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DGDispatch
Patients With Gastrointestinal Stromal Tumour Have Increased Risk of Second, Non-GIST Malignancies: Presented at ASCO
By Bruce Sylvester
ORLANDO, Fla -- June 1, 2009 -- Due to a high rate of other malignancies, patients diagnosed with gastrointestinal stromal tumour (GIST) should be evaluated regularly for other tumour sites, researchers reported here at the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO).
"We found that patients with GIST are at about a 20% [increased] risk of developing a second malignancy, and rigourous, ongoing evaluation of these patients is necessary," said presenter and investigator Jonathan Trent, MD, University of Texas M. D. Anderson Cancer Center, Houston, Texas, on May 31.
Dr. Trent and colleagues evaluated data from 783 patients with GIST who were treated at the M. D. Anderson Cancer Center from 1995 to 2007. Data were evaluated for gender, age at diagnosis of cancer, follow-up time after diagnosis, and death.
Male/female ratio was 1.5 and 1.3 in subjects with GIST and other primary compared with those with GIST-only. Median age of GIST diagnosis was 57 years for patients with GIST-only and 68 years for patients with GIST and other primary.
Of the 783 subjects, 154 (20%) had at least 1 other primary other than GIST. This included tumours not diagnosed as a metastasis, and invasion or recurrence of GIST excluding nonmelanoma skin cancer.
The stomach was the frequent site of occurrence in GIST-only and GIST plus other primary subjects.
Total primaries developed before diagnosis of GIST was higher (134) than primaries developed after GIST diagnosis (53).
The most frequent primary tumour sites identified before diagnosis of GIST were prostate (25), breast (12), oesophagus (9), kidney (7), and melanoma (6). The most frequent primary tumour sites found after the diagnosis of GIST were lung (5) and kidney (5).
The 5-year survival rate was 68% for patients with GIST plus other primary, when the other primary occurred before GIST and 61% for patients with GIST plus other primary when the other primary was found after diagnosis.
The 5-year survival rate was 58% for patients with GIST only, and 49% for patients with GIST and 2 or more other primaries (P = .002).
"Our analysis of patients with GIST over a period of 12 years resulted in the identification of a spectrum of second malignancies that occur in patients with GIST," the authors concluded. "Thus, surveillance is an important component of the management of GIST patients."
[Presentation title: Gastrointestinal Stromal Tumor Associated With Other Primaries: A Study of 154 Patients. Abstract 10567]
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