title: Incidence and clinicopathologic features of gastrointestinal stromal tumors. A population-based study.
abstract: BACKGROUND
  Although the diagnostic criteria and pathogenesis of gastrointestinal stromal tumors (GIST) have recently been elucidated, knowledge of the epidemiology of this malignancy is still limited. This study examined the incidence of GIST in the province of Modena, including pathologic features and clinical outcome.
  
  
  METHODS
  Gastrointestinal mesenchymal tumors identified by the Modena Cancer Registry between 1991 and 2004 were analyzed with an immunohistochemical panel that included staining for CD-117 and PDGFRalpha. Size, mitotic rate, and other pathologic parameters were recorded. Each tumor was categorized into National Institutes of Health risk categories (very low, low, intermediate, and high risk).
  
  
  RESULTS
  One hundred twenty-four cases were classified as GIST. The age-adjusted incidence rate was 6.6 per million. Seventy-five percent of patients were symptomatic; 34% had a previous or concomitant history of cancer. High-risk features were present in 47% of cases. Seventy-eight percent were submitted to radical surgery. After complete resection, the 5-year disease-free survival rates were 94%, 92%, 100%, and 40% for patients at very low, low, intermediate, and high risk, respectively. In multivariate analysis, high risk was the main predictor of recurrence.
  
  
  CONCLUSIONS
  This population-based study shows that the incidence of GIST in Northern Italy is comparable to that reported in other European countries. Survival was favorable in lower risk categories and in most of the resected cases. In our study, resected patients at very low, low, and intermediate risk had a similar outcome. Our data support the need to consider high-risk patients after complete surgical resection for treatment with the best available approach.
authors: Department of Oncology and Haematology, University of Modena and Reggio Emilia, Modena, Italy. c.mucciarini@ausl.mo.it
authors: Claudia
authors: C
authors: Mucciarini
authors: Giulio
authors: G
authors: Rossi
authors: Federica
authors: F
authors: Bertolini
authors: Riccardo
authors: R
authors: Valli
authors: Claudia
authors: C
authors: Cirilli
authors: Ivan
authors: I
authors: Rashid
authors: Luigi
authors: L
authors: Marcheselli
authors: Gabriele
authors: G
authors: Luppi
authors: Massimo
authors: M
authors: Federico
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D015996:Survival Rate / Q000639:trends