title: Ten-year review of gastrointestinal stromal tumours at a tertiary referral hospital in New Zealand.
abstract: BACKGROUND
  Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract and make up 1-2% of all gastrointestinal malignancies. Traditionally, the treatment of choice for primary disease is surgical resection; however, no single surgeon or institution gets extensive exposure to these patients so appropriate decision-making is difficult, particularly since the introduction of the tyrosine kinase inhibitor imatinib, which has become an important additional management tool.
  
  
  METHODS
  All patients were diagnosed and treated for GISTs in Christchurch Hospital (Christchurch, New Zealand) between 1 January 2000 and 31 December 2010. We maintain a prospective database of all patients with GISTs. Data on clinical and histopathological variables, management and survival outcomes were recorded. These were then reviewed.
  
  
  RESULTS
  There were 93 patients in this study. Fifty were women. Median age was 69 (interquartile range (IQR) 59-76) years. Fifty-one tumours were located in the stomach, 27 in the small bowel, six in the colon, three in the oesophagus, one in the rectum and five were extra-gastrointestinal. In total, 22 patients received imatinib therapy; four patients with metastatic disease had imatinib as sole therapy. The median follow-up was 58 (IQR 30-90) months. The 5-year overall survival and disease-free survival (DFS) for the entire study population was 69% and 64%, respectively. The 5-year DFS was higher for all patients who have localized disease when compared with those who have metastatic disease (76% versus 28%, P-value 0.001).
  
  
  CONCLUSIONS
  Surgery aiming at an R0 resection remains the mainstay of treatment. We propose the most effective way to grow the knowledge base in New Zealand is the establishment of a national register, thereby allowing better clinical decision-making by interpretation of a larger data set.
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Joey
authors: J
authors: Siu
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Michael
authors: M
authors: Lim
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Jesse
authors: J
authors: Fischer
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Bruce
authors: B
authors: Dobbs
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Chris
authors: C
authors: Wakeman
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Andrew
authors: A
authors: Ing
authors: Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors: Frank
authors: F
authors: Frizelle
mesh_terms: D000368:Aged; D000066491:Clinical Decision-Making; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011379:Prognosis; D016019:Survival Analysis; D062606:Tertiary Care Centers; D016896:Treatment Outcome
chemical_list: D000068877:Imatinib Mesylate
keywords: GIST; gastrointestinal stromal tumours; imatinib; tyrosine kinase inhibitors