1. Risk Stratification (Miettinen) Mutational status results (N=50)
Ten year prospective experience of Gastrointestinal stromal tumours (GISTS) from the Cambridge GIST Study Group, United Kingdom V R Bulusu, H Hatcher, R H Hardwick, N Carroll, S Pursglove, V Save, P Safranek, H M Earl. Cambridge University Hospitals, Cambridge UK
Background: Cambridge GIST Study Group was formed in GIST specialist multidisciplinary team (MDT) and GIST clinic were established with central review of histology/radiology and overall management plans. We present 10 year experience of our prospective database which formed the template for the United Kingdom national GIST registry.
Methods: All patients who have been referred to the GIST MDT were included in this study. The following data was prospectively collected:
Patient demographics *Systemic therapies
Presenting symptoms *Surgical interventions
GISTS: Site, Size, Mitotic index
Mutational status (where available)
Risk stratification *Other tumours in GIST pts
Histology
Spindle cell 84%
Mixed 12%
Epithelioid 4%
Fig 1. Spindle cell GIST Fig 2. Epithelioid GIST
Risk Stratification (Miettinen)
Very low/low risk 57%
Intermediate 16%
High 27%
Fig 3. Micro GIST Fig 4. Large Gastric GIST
Tumour SiteS (Fig 5)
Stomach %
Small bowel %
EGISTS %
Colorectal %
Duodenum %
Oesophagus %
Results: 260 pts were reviewed in the GIST MDT. 29 pts had endoscopic/imaging diagnosis of GIST and were not included in the final analysis. 41 pts had other tumours diagnosed when GIST was initially suspected. Histologically confirmed GISTS 190.
N= 190 Male: Female 52%:48%
Median age 64 yrs (range 14-94) , 4% < 40 years
84% had surgical interventions ( primary or metastases)
9% had resections on Imatinib/Sunitinib
Tumour size cm
Ruptured GISTS (spontaneous or intraoperative) 2.6%
GIST in Meckel’s diverticulum 1%
14% of GIST pts had other tumours either prior to diagnosis or during treatment/follow up of GISTS
Mutational status results (N=50)
KIT Exon 11 64% PDGFRA 14%
KIT Exon 9 5.5% WILD type 11%
KIT Exon %
Conclusions: This is the first prospective regional GIST registry data from UK. Our results mirror other large prospective series. GISTS should be managed by an experienced multidisciplinary team to provide a high quality service.