TREATMENT OUTCOME FOLLOWING IMATINIB IN PATIENTS WITH GASTROINTESTINAL STROMAL TUMOUR (GIST) IN KHYBER PAKHTUNKHWA, PAKISTAN

Abstract

Objective: Gastrointestinal stromal tumours (GIST) are rare tumours of gastrointestinal tract. The association of their characteristics with patient survival are poorly defined. A risk stratification is critical to optimize the treatment strategy despite an improved survival with adjuvant therapies, such as Imatinib. We aimed to identify the risk factors and treatment outcome of GIST patients.

Methodology: We evaluated the demography and disease characteristics of patients with GIST presenting to Hayatabad Medical Complex (HMC), Peshawar, Pakistan. The diagnostic criteria included characteristic morphology and CD117/DOG-1 positivity. We performed pre- and post-surgical CT scans and treated patients with metastatic disease or high-risk factors with daily Imatinib of 400–800 mg.

Results: Total 150 (67.87%) patients were male while 71 (32.33%) patients were female. Median age at the time of diagnosis was 50 years (range 17–75 years). Commonest site at presentation was stomach in 120 (54.30%) patients, small intestine in 60 (27.15%) patients, colorectal in 20 (9.05%) patients and other cases were 21 (9.50%). Tumor size was 2cm or less in 18(8.14%) patients, > 2 - ?5 cm in 24 (10.86%) patients, >5cm - ?10cm in 68 (30.77%) patients while 93 (42.09%) patients had tumors >10 cm. In 18 (8.14%) patients, tumor size at presentation was unknown.

Conclusion: We report an earlier age at onset in our region than most Western countries. Most of our patients had aggressive disease features. Response to Imatinib was found to be satisfactory while treatment was well tolerated.