title: Gastrointestinal stromal tumor: analysis of 146 cases of the center of reference of the National Cancer Institute--INCA.
abstract: OBJECTIVE
  To evaluate the treatment of GIST in INCA.
  
  
  METHODS
  We conducted a retrospective analysis of all cases of GIST treated at INCA in the period from 1997 to 2009.
  
  
  RESULTS
  We analyzed 146 patients with a mean age of 44.5 years and female predominance. The main symptom was abdominal pain. We observed the occurrence of a second primary tumor in 22% of cases and 92% of the immunohistochemistry exams were positive for CD117. The most frequent location was in the stomach and the high-risk group was predominant. Surgery was considered R0 (extensive) in 70% of the cases and the main sites of metastases were liver and peritoneum. Overall survival in two and five years was, respectively, 86% and 59%. There was a significant difference between overall survival (p = 0.29) of the high-risk group versus the other.
  
  
  CONCLUSIONS
  Our patients presented mainly in the form of high-risk disease, with obvious impact on survival. The use of imatinib improved survival of patients with recurrent and metastatic disease. We should study its use in the setting of adjuvant and neoadjuvant therapy to improve results of the high risk group. The creation of reference centers is a need for the study of rare diseases.
authors.affiliation: Serviço de Cirurgia Abdomino-Pelvica, INCA, Rio de Janeiro, RJ, BR. doutor@eduardolinhares.com.br
authors.forename: Eduardo
authors.initials: E
authors.lastname: Linhares
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Gonçalves
authors.forename: Marcus
authors.initials: M
authors.lastname: Valadão
authors.forename: Bruno
authors.initials: B
authors.lastname: Vilhena
authors.forename: Daniel
authors.initials: D
authors.lastname: Herchenhorn
authors.forename: Sergio
authors.initials: S
authors.lastname: Romano
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Ferreira
authors.forename: Carlos Gil
authors.initials: CG
authors.lastname: Ferreira
authors.forename: Cintia de Araujo
authors.initials: Cde A
authors.lastname: Ramos
authors.forename: José Paulo
authors.initials: JP
authors.lastname: de Jesus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D002648:Child; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult