title: Clinicopathological study of 113 gastrointestinal stromal tumors.
abstract: BACKGROUND
  Gastrointestinal stromal tumor (GIST) is the most common sarcoma of the gastrointestinal tract. A retrospective study was done to evaluate the clinical and pathological features and the effect of adjuvant treatment with imatinib.
  
  
  METHODS
  The case records of 113 GIST patients were retrospectively reviewed and the clinicopathological features, treatments, and outcomes were recorded.
  
  
  RESULTS
  There were 82 males and 31 females, with a median age of 51 years. All patients were symptomatic (mean duration 4 months) and abdominal pain was the most common symptom. The primary sites of GIST were small intestine (38), stomach (36), and others (39). The tumor diameter on imaging varied from 1 to 26 (mean 10.9) cm. Thirty percent of patients presented with metastasis. There was no association between tumor size and presence of metastasis (p = 0.9). Most common histology was spindle cell morphology followed by mixed spindle cell and epithelioid morphology. Seventy percent patients had high risk (HR) category as per Fletcher risk score. Fifty-three percent had curative resection, after which 34 % had adjuvant imatinib therapy. Recurrence rates were significantly lower in patients receiving adjuvant imatinib therapy (p = 0.003). No statistically significant association was noted between HR Fletcher score, Mib score >10, tumor size >10 cm, and the risk of recurrence (p = 0.29, 0.07, and 0.87, respectively). Liver was the most common site of metastasis. Side effects were tolerable and edema and fluid retention were the commonest.
  
  
  CONCLUSIONS
  Sites of GIST in Indian patients were different from those in western studies. Adjuvant imatinib therapy significantly reduced the risk of recurrence.
authors.affiliation: Tata Memorial Hospital, Parel, Mumbai, India. rahul_bhalgami@hotmail.com
authors.forename: Rahul
authors.initials: R
authors.lastname: Bhalgami
authors.forename: Kak
authors.initials: K
authors.lastname: Manish
authors.forename: Prachi
authors.initials: P
authors.lastname: Patil
authors.forename: Shaesta
authors.initials: S
authors.lastname: Mehta
authors.forename: K M
authors.initials: KM
authors.lastname: Mohandas
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate