Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era--a population-based study in western Sweden.

摘要: BACKGROUND Recent breakthroughs regarding gastrointestinal stromal tumors (GIST) and their pathogenesis have redefined diagnostic criteria led to the development of molecularly targeted drug therapy. New treatment options mandate more accurate information incidence, prevalence, clinical behavior, prognostic factors GIST. METHODS All patients (n = 1460) who potentially had GIST diagnosed from 1983 2000 in western Sweden (population, 1.3–1.6 million) were reviewed, 288 with primary identified. The incidence prevalence determined, predictive factors, including current risk-group stratifications, analyzed statistically. RESULTS Ninety percent GISTs detected clinically due symptoms (69%) or incidental findings at surgery (21%); remaining 10% found autopsy. Forty-four symptomatic, categorized as high risk (29%) overtly malignant (15%), tumor-related deaths occurring 63% 83% patients, respectively (estimated median survival, 40 months 16 months, respectively). Tumor-related occurred only 2 170 (1.2%) very-low-risk, low-risk, intermediate-risk tumors. annual was 14.5 per million. all groups 129 million (31 for high-risk group group). CONCLUSIONS GIST has been under recognized: Its aggressiveness also underestimated. Currently existing stratification systems based on tumor size mitotic rate delineate a poor prognosis. Prognostication can be refined using proposed score solely proliferative index. Cancer 2005. © 2005 American Society.