The impact of additional malignancies in patients diagnosed with gastrointestinal stromal tumors.
A higher incidence of additional malignancies has been described in patients diagnosed with gastrointestinal stromal tumors (GIST). This study aimed to identify risk factors for developing additional malignancies in patients diagnosed with GIST and evaluate the impact on survival. Individuals diagnosed with GIST from 2001 to2009 were identified from the SEER database. Logistic regression was used to identify predictors of additional malignancies and Cox-proportional hazards regression used to identify predictors of survival. In the study period, 1705 cases of GIST were identified, with 181 (10.6%) patients developing additional malignancies. Colorectal cancer was the most common cancer developing within 6 months of GIST diagnosis (30%). The median time to diagnosis of a malignancy after 6 months of GIST diagnosis was 21.9 months. Older age (p < 0.0001) and extraoesophagogastric GIST (p = 0.0027) were significant prognostic factors associated with additional malignancies. The overall 5-year survival was 65%, with the presence of additional malignancies within 6 months of GIST diagnosis associated with poor overall survival (54%, HR 1.55 1.05-2.3 95% CI, p = 0.04). Predictive factors of additional malignancies in patients diagnosed with GIST are increasing age and the primary disease site. Developing additional malignancies within 6 months of GIST diagnosis is associated with poorer overall survival. Targeted surveillance may be warranted in patients diagnosed with GIST that are at high risk of developing additional malignancies.
The Sarcoma Unit, Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
Myles J
MJ
Smith
The Sarcoma Unit, Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
Henry G
HG
Smith
Department of Public Health Sciences, Queen's University Kingston, Ontario, Canada.
Alyson L
AL
Mahar
Division of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences, University of Toronto Centre, Ontario, Canada.
Calvin
C
Law
Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences, University of Toronto Centre, Ontario, Canada.
Yoo-Joung
YJ
Ko
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D055815:Young Adult
colorectal care; gastrointestinal stromal tumors; gist; sarcoma; second cancers; second primary care; seer; survival