Evaluation of Gastro Intestinal Stromal Tumor in a Tertiary Care Center

INTRODUCTION: Gastrointestinal stromal tumour (GIST) is an uncommon entity in clinical practice. It accounts for only <1% of all Gastrointestinal (GI) malignancies.

Stomach is the commonest site for this tumour. Other sites of GI tract are also affected with GIST.

AIMS AND OBJECTIVES: This study aimed   evaluate the prognostic factors, and recurrence patterns among the patients of eastern India. 

MATERIAL AND METHODS: This was a retrospective observational study which was conducted at the Department of Pathology in a tertiary care centre of eastern India. The specimens sent for HPE during the period June, 2018 to June, 2023 were included in the study. A total number of 2897 GI specimens sent to the Department for histopathological examinations were selected for the study. Out of which 77 specimens were diagnosed as GIST.  The information of the vital parameters of the patient, type of tumour and type of treatments offered were collected for evaluation. The histological examinations relied on morphological features on Hematoxylin & Eosin stain and confirmation with immunohistochemistry markers CD34 and CD117 and S100. Patients with operable GIST underwent

Surgery followed by adjuvant therapy. Patients with inoperable/ borderline operable disease underwent neoadjuvant Tab. Imatinib 400 mg/day followed by reassessment for surgery. 

RESULTS: The mean (±S.D.)  age of the patients was 54.58±11.24 years with range of 28 -74 years and the median age was 54 years. 66.2% of the patients were with age< 60 years (p<0.001). Proportion of females (54.5%) was higher than males (45.5%) but it was not significant. Stomach (54.5%) was the most common site of tumour which was significantly higher than small intestine (27.3%) and large intestine (18.2%) (p<0.0001).  At presentation non-metastatic cases (62.3%) were significantly higher than metastatic (35.1%) and locally recurrent cases (2.6%) (p<0.0001). In most of the cases the mitotic rate was between 5 – 10 /50 HPF (53.2%) which was significantly higher than mitotic rate <5/50 HPF (32.5%) and >10/50 (14.3%) (p=0.0042).  Spindle cell type tumour (71.4%) was significantly higher than mixed (Spindle and Epithelioid) (20.8%) and Epithelioid type tumour (7.8%) (p<0.0001).