title: Clinical outcomes of gastrointestinal stromal tumor in southern Thailand.
abstract: OBJECTIVE
  To review a single institutional experience in clinical management of gastrointestinal stromal tumors (GIST) and analyze for factors determining treatment outcome.
  
  
  METHODS
  Clinicopathological data of patients with a diagnosis of GIST who were treated at our institute during November 2004 to September 2009 were retrospectively reviewed.
  
  
  RESULTS
  Ninety-nine cases were included in the analysis. Primary tumor sites were at the stomach in and small bowel in 44% and 33%, respectively. Thirty-one cases already had metastasis at presentation and the most common metastatic site was the liver. Sixty-four cases (65%) were in the high-risk category. Surgical treatment was performed in 77 cases (78%), 3 of whom received upfront targeted therapy. Complete resection was achieved in 56 cases (73% of operative cases) and of whom 27 developed local recurrence or distant metastasis at a median duration of 2 years. Imatinib was given as a primary therapy in unresectable cases (25 cases) and as an adjuvant in cases with residual tumor (21 cases). Targeted therapy gave partial response in 7 cases (15%), stable disease in 27 cases (57%) and progressive disease in 13 cases (28%). Four-year overall survival was 74% (95% CI: 61%-83%). Univariate survival analysis found that low-risk tumor, gastric site, complete resection and response to imatinib were associated with better survival.
  
  
  CONCLUSIONS
  The overall outcomes of GIST can be predicted by risk-categorization. Surgery alone may not be a curative treatment for GIST. Response to targeted therapy is a crucial survival determinant in these patients.
authors: Kittima Pornsuksiri, Siripong Chewatanakornkul, Walawee Chaiyapan, Surasak Sangkhathat, Department of Surgery and Tumor Biology Research Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
authors: Kittima
authors: K
authors: Pornsuksiri
authors: Siripong
authors: S
authors: Chewatanakornkul
authors: Samornmas
authors: S
authors: Kanngurn
authors: Wanwisa
authors: W
authors: Maneechay
authors: Walawee
authors: W
authors: Chaiyapan
authors: Surasak
authors: S
authors: Sangkhathat
keywords: Gastrointestinal stromal tumor; Overall survival; Progress free survival; Progressive disease; Targeted therapy