Two hundred gastrointestinal stromal tumors - Recurrence patterns and prognostic factors for survival

Objective To analyze the outcome of 200 patients with gastrointestinal stromal tumor (GIST) who were treated at a single institution and followed up prospective ly. Summary Background Data A GIST is a visceral sarcoma that arises from the gastrointestinal tract. S urgical resection is the mainstay of treatment because adjuvant therapy is unproven. Methods Two hundred patients with malignant GIST were admitted and treated at Memor ial Hospital during the past 16 years. Patient, tumor, and treatment variab les were analyzed to identify patterns of tumor recurrence and factors that predict survival. Results Of the 200 patients, 46% had primary disease without metastasis, 47% had me tastasis, and 7% had isolated local recurrence. In patients with primary di sease who underwent complete resection of gross disease (n = 80), the 5-yea r actuarial survival rate was 54%, and survival was predicted by tumor size but not microscopic margins of resection, Recurrence of disease after rese ction was predominantly intraabdominal and involved the original tumor site , peritoneum, and liver. Conclusions GISTs are uncommon sarcomas. Tumor size predicts disease-specific survival in patients with primary disease who undergo complete gross resection. Tumo r recurrence tends to be intraabdominal. Investigational protocols are indi cated to reduce the rate of recurrence after resection and to improve the o utcome for patients with GIST.