Gastrointestinal stromal tumors-frequency, malignancy, and new prognostic factors: The experience of a single institution

Pathology Research and Practice

Volumn 204, Issue 4, 2008, Pages 219-233

  Bertolini, Valentina ^a   Chiaravalli, Anna Maria ^a   Klersy, Catherine ^b   Placidi, Claudia ^a   Marchet, Silvia ^a   Boni, Luigi ^c   Capella, Carlo ^a  

^a University of Varese   (Italy)

^b FONDAZIONE IRCCS POLICLINICO SAN MATTEO   (Italy)

^c UNIVERSITY OF INSUBRIA   (Italy)

Author keywords

GIST; Malignant behavior; Prognosis

Indexed keywords

STEM CELL FACTOR; STEM CELL FACTOR RECEPTOR;

ADULT; AGE DISTRIBUTION; AGED; ARTICLE; CANCER INCIDENCE; CANCER LOCALIZATION; CANCER MORTALITY; CANCER SURVIVAL; CLINICAL FEATURE; COLON TUMOR; CONTROLLED STUDY; FEMALE; FOLLOW UP; GASTROINTESTINAL STROMAL TUMOR; HUMAN; HUMAN TISSUE; IMMUNOHISTOCHEMISTRY; LEIOMYOMA; LEIOMYOSARCOMA; LONG TERM CARE; MAJOR CLINICAL STUDY; MALE; MESENTERY TUMOR; METASTASIS; MULTIVARIATE ANALYSIS; NEURILEMOMA; OMENTUM; PATIENT MONITORING; PREDICTION; PROGNOSIS; RECTUM TUMOR; RISK ASSESSMENT; SMALL INTESTINE TUMOR; TUMOR RECURRENCE;

ADULT; AGE FACTORS; AGED; DISEASE-FREE SURVIVAL; FEMALE; GASTROINTESTINAL STROMAL TUMORS; HEALTH STATUS INDICATORS; HUMANS; KAPLAN-MEIERS ESTIMATE; MALE; MIDDLE AGED; MODELS, BIOLOGICAL; NEOPLASM INVASIVENESS; NEOPLASM METASTASIS; NEOPLASM RECURRENCE, LOCAL; NEOPLASM STAGING; PROPORTIONAL HAZARDS MODELS; RISK ASSESSMENT; RISK FACTORS; TIME FACTORS; TREATMENT OUTCOME;

EID: 40849137419     PISSN: 03440338     EISSN: 16180631     Source Type: Journal    
DOI: 10.1016/j.prp.2007.12.005     Document Type: Article

References (56)

1. Agaimy A., Wunsch P.H., Hofstaedter F., Blaszyk H., Rummele P., Gaumann A., Dietmaier W., and Hartmann A. Minute gastric sclerosing stromal tumors (GIST tumorlets) are common in adults and frequently show c-KIT mutations. Am. J. Surg. Pathol. 31 (2007) 113-120
2. Al-Bozom I.A. p53 expression in gastrointestinal stromal tumors. Pathol. Int. 51 (2001) 519-523
3. Antonescu C.R., Besmer P., Guo T., Arkun K., Hom G., Koryotowski B., Leversha M.A., Jeffrey P.D., Desantis D., Singer S., Brennan M.F., Maki R.G., and DeMatteo R.P. Acquired resistance to imatinib in gastrointestinal stromal tumor occurs through secondary gene mutation. Clin. Cancer Res. 11 (2005) 4182-4190
4. Bertin M., Angriman I., Scarpa M., Mencarelli R., Ranzato R., Ruffolo C., Polese L., Iacobone M., and D'Amico D.F. Prognosis of gastrointestinal stromal tumors. Hepatogastroenterology 54 (2007) 124-128
5. Brainard J.A., and Goldblum J.R. Stromal tumors of the jejunum and ileum: a clinicopathologic study of 39 cases. Am. J. Surg. Pathol. 21 (1997) 407-416
6. Corless C.L., McGreevey L., Haley A., Town A., and Heinrich M.C. KIT mutations are common in incidental gastrointestinal stromal tumors one centimeter or less in size. Am. J. Pathol. 160 (2002) 1567-1572
7. Corless C.L., Fletcher J.A., and Heinrich M.C. Biology of gastrointestinal stromal tumors. J. Clin. Oncol. 22 (2004) 3813-3825
8. Cunningham R.E., Abbondanzo S.L., Chu W.S., Emory T.S., Sobin L.H., and O'Leary T.J. Apoptosis, bcl-2 expression, and p53 expression in gastrointestinal stromal/smooth muscle tumors. Appl. Immunohistochem. Mol. Morphol. 9 (2001) 19-23
9. Dagher R., Cohen M., Williams G., Rothmann M., Gobburu J., Robbie G., Rahman A., Chen G., Staten A., Griebel D., and Pazdur R. Approval summary: imatinib mesylate in the treatment of metastatic and/or unresectable malignant gastrointestinal stromal tumors. Clin. Cancer Res. 8 (2002) 3034-3038
10. Debiec-Rychter M., Dumez H., Judson I., Wasag B., Verweij J., Brown M., Dimitrijevic S., Sciot R., Stul M., Vranck H., Scurr M., Hagemeijer A., van Glabbeke M., and van Oosterom A.T. EORTC Soft Tissue and Bone Sarcoma Group. Use of c-KIT/PDGFRA mutational analysis to predict the clinical response to imatinib in patients with advanced gastrointestinal stromal tumors entered on phase I and II studies of the EORTC Soft Tissue and Bone Sarcoma Group. Eur. J. Cancer 40 (2004) 689-695
11. Demetri G.D., von Mehren M., Blanke C.D., Van den Abbeele A.D., Eisenberg B., Roberts P.J., Heinrich M.C., Tuveson D.A., Singer S., Janicek M., Fletcher J.A., Silverman S.G., Silberman S.L., Capdeville R., Kiese B., Peng B., Dimitrijevic S., Druker B.J., Corless C., Fletcher C.D., and Joensuu H. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N. Engl. J. Med. 347 (2002) 472-480
12. Demetri G.D., van Oosterom A.T., Garrett C.R., Blackstein M.E., Shah M.H., Verweij J., McArthur G., Judson I.R., Heinrich M.C., Morgan J.A., Desai J., Fletcher C.D., George S., Bello C.L., Huang X., Baum C.M., and Casali P.G. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumor after failure of imatinib: a randomised controlled trial. Lancet 368 (2006) 1329-1338
13. Feakins R.M. The expression of p53 and bcl-2 in gastrointestinal stromal tumors is associated with anatomical site, and p53 expression is associated with grade and clinical outcome. Histopathology 46 (2005) 270-279
14. Fletcher C.D., Berman J.J., Corless C., Gorstein F., Lasota J., Longley B.J., Miettinen M., O'Leary T.J., Remotti H., Rubin B.P., Shmookler B., Sobin L.H., and Weiss S.W. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum. Pathol. 33 (2002) 459-465
15. Goettsch W.G., Bos S.D., Breekveldt-Postma N., Casparie M., Herings R.M., and Hogendoorn P.C. Incidence of gastrointestinal stromal tumors is underestimated: results of a nation-wide study. Eur. J. Cancer 41 (2005) 2868-2872
16. Goldblum J.R. DNA ploidy and proliferative index in gastrointestinal stromal tumors. Hum. Pathol. 29 (1998) 102
17. Goodman V.L., Rock E.P., Dagher R., Ramchandani R.P., Abraham S., Gobburu J.V., Booth B.P., Verbois S.L., Morse D.E., Liang C.Y., Chidambaram N., Jiang J.X., Tang S., Mahjoob K., Justice R., and Pazdur R. Approval summary: sunitinib for the treatment of imatinib refractory or intolerant gastrointestinal stromal tumors and advanced renal cell carcinoma. Clin. Cancer Res. 13 (2007) 1367-1373
18. Heinrich M.C., Corless C.L., Duensing A., McGreevey L., Chen C.J., Joseph N., Singer S., Griffith D.J., Haley A., Town A., Demetri G.D., Fletcher C.D., and Fletcher J.A. PDGFRA activating mutations in gastrointestinal stromal tumors. Science 299 (2003) 708-710
19. Heinrich M.C., Corless C.L., Demetri G.D., Blanke C.D., von Mehren M., Joensuu H., McGreevey L.S., Chen C.J., Van den Abbeele A.D., Druker B.J., Kiese B., Eisenberg B., Roberts P.J., Singer S., Fletcher C.D., Silberman S., Dimitrijevic S., and Fletcher J.A. Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J. Clin. Oncol. 21 (2003) 4342-4349
20. Heinrich M.C., Corless C.L., Blanke C.D., Demetri G.D., Joensuu H., Roberts P.J., Eisenberg B.L., von Mehren M., Fletcher C.D., Sandau K., McDougall K., Ou W.B., Chen C.J., and Fletcher J.A. Molecular correlates of imatinib resistance in gastrointestinal stromal tumors. J. Clin. Oncol. 24 (2006) 4764-4774
21. Hirota S., Isozaki K., Moriyama Y., Hashimoto K., Nishida T., Ishiguro S., Kawano K., Hanada M., Kurata A., Takeda M., Muhammad Tunio G., Matsuzawa Y., Kanakura Y., Shinomura Y., and Kitamura Y. Gain of function mutations of c-kit in human gastrointestinal stromal tumors. Science 279 (1998) 577-580
22. Hornick J.L., and Fletcher C.D. The role of KIT in the management of patients with gastrointestinal stromal tumors. Hum. Pathol. 38 (2007) 679-687
23. Hsu K.H., Yang T.M., Shan Y.S., and Lin P.W. Tumor size is a major determinant of recurrence in patients with resectable gastrointestinal stromal tumor. Am. J. Surg. 194 (2007) 148-152
24. Huang H.Y., Huang W.W., Lin C.N., Eng H.L., Li S.H., Li C.F., Lu D., Yu S.C., and Hsiung C.Y. Immunohistochemical expression of p16INK4A, Ki-67, and Mcm2 proteins in gastrointestinal stromal tumors: prognostic implications and correlations with risk stratification of NIH consensus criteria. Ann. Surg. Oncol. 13 (2006) 1633-1644
25. Huang H.Y., Li C.F., Huang W.W., Hu T.H., Lin C.N., Uen Y.H., Hsiung C.Y., and Lu D. A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: a subdivision of the original high-risk group on the basis of outcome. Surgery 141 (2007) 748-756
26. Kindblom L.G., Remotti H.E., Aldenborg F., and Meis-Kindblom J.M. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am. J. Pathol. 152 (1998) 1259-1269
27. Lasota J., and Miettinen M. KIT and PDGFRA mutations in gastrointestinal stromal tumors (GISTs). Semin. Diagn. Pathol. 23 (2006) 91-102
28. Lasota J., Vel Dobosz A.J., Wasag B., Wozniak E., Kraszewska A., Michej W., Ptaszynski K., Rutkowski P., Sarlomo-Rikala M., Steigen S.E., Schneider-Stock R., Stachura J., Chosia M., Ogun G., Ruka W., Siedlecki J.A., and Miettinen M. Presence of homozygous KIT exon 11 mutations is strongly associated with malignant clinical behavior in gastrointestinal stromal tumors. Lab. Invest. 87 (2007) 1029-1041
29. Lux M.L., Rubin B.P., Biase T.L., Chen C.J., Maclure T., Demetri G., Xiao S., Singer S., Fletcher C.D., and Fletcher J.A. KIT extracellular and kinase domain mutations in gastrointestinal stromal tumors. Am. J. Pathol. 156 (2000) 791-795
30. Miettinen M., and Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin. Diagn. Pathol. 23 (2006) 70-83
31. Miettinen M., Monihan J.M., Sarlomo-Rikala M., Kovatich A.J., Carr N.J., Emory T.S., and Sobin L.H. Gastrointestinal stromal tumors/smooth muscle tumors (GISTs) primary in the omentum and mesentery: clinicopathologic and immunohistochemical study of 26 cases. Am. J. Surg. Pathol. 23 (1999) 1109-1118
32. Miettinen M., Sarlomo-Rikala M., Sobin L.H., and Lasota J. Gastrointestinal stromal tumors and leiomyosarcomas in the colon: a clinicopathologic, immunohistochemical, and molecular genetic study of 44 cases. Am. J. Surg. Pathol. 24 (2000) 1339-1352
33. Miettinen M., Furlong M., Sarlomo-Rikala M., Burke A., Sobin L.H., and Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas and leiomyosarcomas in the rectum and anus: clinicopathologic, immunohistochemical and molecular genetic study of 144 cases. Am. J. Surg. Pathol. 25 (2001) 1122-1133
34. Miettinen M., El-Rifai W., Sobin L.H., and Lasota J. Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Hum. Pathol. 33 (2002) 478-483
35. Miettinen M., Kopczynski J., Makhlouf H.R., Sarlomo-Rikala M., Gyorffy H., Burke A., Sobin L.H., and Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am. J. Surg. Pathol. 27 (2003) 625-641
36. Miettinen M., Sobin L.H., and Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long term follow up. Am. J. Surg. Pathol. 9 (2005) 52-68
37. Miettinen M., Makhlouf H., Sobin L.H., and Lasota J. Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am. J. Surg. Pathol. 30 (2006) 477-489
38. Miselli F.C., Casieri P., Negri T., Orsenigo M., Lagonigro M.S., Gronchi A., Fiore M., Casali P.G., Bertulli R., Carbone A., Pierotti M.A., Tamborini E., and Pilotti S. c-Kit/PDGFRA gene status alterations possibly related to primary imatinib resistance in gastrointestinal stromal tumors. Clin. Cancer Res. 13 (2007) 2369-2377
39. Nakamura N., Yamamoto H., Yao T., Oda Y., Nishiyama K., Imamura M., Yamada T., Nawata T., and Tsuneyoshi M. Prognostic significance of expressions of cell-cycle regulatory proteins in gastrointestinal stromal tumor and the relevance of the risk grade. Hum. Pathol. 36 (2005) 828-837
40. Nilsson B., Bumming P., Meis-Kindblom J.M., Oden A., Dortok A., Gustavsson B., Sablinska K., and Kindblom L.G. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era. Cancer 103 (2005) 821-829
41. Noguchi T., Sato T., Takeno S., Uchida Y., Kashima K., Yokoyama S., and Muller W. Biological analysis of gastrointestinal stromal tumors. Oncol. Rep. 9 (2002) 1277-1282
42. Reith J.D., Goldblum J.R., Lyles R.H., and Weiss S.W. Extragastrointestinal (soft tissue) stromal tumors: an analysis of 48 cases with emphasis on histologic predictors of outcome. Mod. Pathol. 13 (2000) 577-585
43. Riddell R.H. Mesenchimal tumors: stromal tumors. In: Rosai J., and Sobin L.H. (Eds). Atlas of Tumor Pathology. Tumors of the Intestine (2002), Armed Forced Institute of Pathology, Washington, DC 325-346
44. Rubiò J., Marcos-Gragera R., Ortiz M.R., Mirò J., Vilardell L., Girones J., Hernandez-Yague X., Codina-Cazador A., Bernadò L., Izquierdo A., and Colomer R. Population-based incidence and survival of gastrointestinal stromal tumors (GIST) in Girona, Spain. Eur. J. Cancer 43 (2007) 144-148
45. Rudolph P., Gloeckner K., Parwaresch R., Harms D., and Schmidt D. Immunophenotype, proliferation, DNA ploidy, and biological behavior of gastrointestinal stromal tumors: a multivariate clinicopathologic study. Hum. Pathol. 29 (1998) 791-800
46. Rudolph P., Chiaravalli A.M., Pauser U., Oschlies I., Hillemanns M., Gobbo M., Marichal M., Eusebi V., Hofler H., Capella C., and Kloppel G. Gastrointestinal mesenchymal tumors-immunophenotypic classification and survival analysis. Virchows Arch. 441 (2002) 238-248
47. Sakurai S., Fukayama M., Kaizaki Y., Saito K., Kanazawa K., Kitamura M., Iwasaki Y., Hishima T., Hayashi Y., and Koike M. Telomerase activity in gastrointestinal stromal tumors. Cancer 83 (1998) 2060-2066
48. Steigen S.E., and Eide T.J. Trends in incidence and survival of mesenchymal neoplasm of the digestive tract within a defined population of northern Norway. APMIS 114 (2006) 192-200
49. Steigen S.E., Eide T.J., Wasag B., Lasota J., and Miettinen M. Mutations in gastrointestinal stromal tumors-a population-based study from Northern Norway. APMIS 115 (2007) 289-298
50. S.E. Steigen, B. Straume, D. Turbin, A.K.W. Chan, S. Leung, T.O. Nielsen, S. Lindal, Clinicopathologic factors and nuclear morphometry as independent prognosticators in KIT positive gastrointestinal stromal tumor, J. Histochem. Cytochem. DOI:10.1369/jhc.7A7333.2007.
51. Tamborini E., Bonadiman L., Greco A., Albertini V., Negri T., Gronchi A., Bertulli R., Colecchia M., Casali P.G., Pierotti M.A., and Pilotti S. A. new mutation in the KIT ATP pocket causes acquired resistance to imatinib in a gastrointestinal stromal tumor patient. Gastroenterology 127 (2004) 294-299
52. Tamborini E., Pricl S., Negri T., Lagonigro M.S., Miselli F., Greco A., Gronchi A., Casali P.G., Ferrone M., Fermeglia M., Carbone A., Pierotti M.A., and Pilotti S. Functional analyses and molecular modeling of two c-Kit mutations responsible for imatinib secondary resistance in GIST patients. Oncogene 25 (2006) 6140-6146
53. Tran T., Davila J.A., and El-Serag H.B. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am. J. Gastroenterol. 100 (2005) 162-168
54. Wardelmann E., Buttner R., Merkelbach-Bruse S., and Schildhaus H.U. Mutation analysis of gastrointestinal stromal tumors: increasing significance for risk assessment and effective targeted therapy. Virchows Arch. 451 (2007) 743-749
55. Yan H., Marchettini P., Acherman Y.I., Gething S.A., Brun E., and Sugarbaker P.H. Prognostic assessment of gastrointestinal stromal tumor. Am. J. Clin. Oncol. 26 (2003) 221-228
56. Yu C.C., Woods A.L., and Levison D.A. The assessment of cellular proliferation by immunohistochemistry: a review of currently available methods and their applications. Histochem. J. 24 (1992) 121-131