Clinicopathological features and treatment outcome of oesophageal gastrointestinal stromal tumour (GIST): A large, retrospective multicenter European study.
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ICR Authors
Authors
Mohammadi, M
IJzerman, NS
Hohenberger, P
Rutkowski, P
Jones, RL
Martin-Broto, J
Gronchi, A
Schöffski, P
Vassos, N
Farag, S
Baia, M
Oosten, AW
Steeghs, N
Desar, IME
Reyners, AKL
van Sandick, JW
Bastiaannet, E
Gelderblom, H
Schrage, Y
IJzerman, NS
Hohenberger, P
Rutkowski, P
Jones, RL
Martin-Broto, J
Gronchi, A
Schöffski, P
Vassos, N
Farag, S
Baia, M
Oosten, AW
Steeghs, N
Desar, IME
Reyners, AKL
van Sandick, JW
Bastiaannet, E
Gelderblom, H
Schrage, Y
Document Type
Journal Article
Date
2021-03-31
Date Accepted
2021-03-09
Abstract
BACKGROUND: Oesophageal gastrointestinal stromal tumours (GISTs) account for ≤1% of all GISTs. Consequently, evidence to guide clinical decision-making is limited. METHODS: Clinicopathological features and outcomes in patients with primary oesophageal GIST from seven European countries were collected retrospectively. RESULTS: Eighty-three patients were identified, and median follow up was 55.0 months. At diagnosis, 59.0% had localized disease, 25.3% locally advanced and 13.3% synchronous metastasis. A biopsy (Fine Needle aspiration n = 29, histological biopsy n = 31) was performed in 60 (72.3%) patients. The mitotic count was low (<5 mitoses/50 High Power Fields (HPF)) in 24 patients and high (≥5 mitoses/50 HPF) in 27 patients. Fifty-one (61.4%) patients underwent surgical or endoscopic resection. The most common reasons to not perform an immediate resection (n = 31) were; unresectable or metastasized GIST, performance status/comorbidity, patient refusal or ongoing neo-adjuvant therapy. The type of resections were enucleation (n = 11), segmental resection (n = 6) and oesophagectomy with gastric conduit reconstruction (n = 33), with median tumour size of 3.3 cm, 4.5 cm and 7.7 cm, respectively. In patients treated with enucleation 18.2% developed recurrent disease. The recurrence rate in patients treated with segmental resection was 16.7% and in patients undergoing oesophagectomy with gastric conduit reconstruction 36.4%. Larger tumours (≥4.0 cm) and high (>5/5hpf) mitotic count were associated with worse disease free survival. CONCLUSION: Based on the current study, enucleation can be recommended for oesophageal GIST smaller than 4 cm, while oesophagectomy should be preserved for larger tumours. Patients with larger tumours (>4 cm) and/or high mitotic count should be treated with adjuvant therapy.
Citation
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2021
Source Title
Publisher
ELSEVIER SCI LTD
ISSN
0748-7983
eISSN
1532-2157
Collections
Research Team
Sarcoma Clinical Trials (R Jones)
Sarcoma Clinical Trials (R Jones)
Sarcoma Clinical Trials (R Jones)