Association Between Gastrointestinal Stromal Tumors and Other Malignancies: It Is Only a Matter of Time ? A Case Series and an Overview of Systematic Reviews
Little is known about the sporadic coincidence of gastrointestinal stromal tumors (GISTs) with second primary tumors (SPTs). The aim of this study is to clarify if there is a clinicopathologic correlation responsible for the synchronous or metachronous occurrence of SPTs in GIST patients.
We carried out a single-center, retrospective analysis on patients with GISTs surgically treated at our institution from January 2019 to June 2019. Two groups of patients were identified: isolated GIST (group A) and GIST associated with SPT (group B). A meta-review was conducted with the aim to examine the published systematic reviews that included studies assessing the SPT risk in GIST patients.
Thirty-nine patients were surgically treated for GIST during the study period, with seven (17.9%) of them having other SPTs. SPTs were most frequent in the colon. Group A patients had a lower mean age at initial diagnosis (56.8 ± 15.2 vs. 73.4 ± 16.6, P = 0.012). No statistically significant difference was found between the two groups in terms of tumor location, mitotic index, Ki-67 expression, risk classification, and imatinib therapy. The overview showed that the cumulative prevalence rate of SPTs ranged from 9.3 to 18.0%. SPTs were more frequent in the gastrointestinal tract (37.9–95.0%), followed by the genitourinary tract.
GIST patients under our care experienced a 17.9% overall risk of developing SPTs with different histology. When comparing patients with isolated GIST and patients with GIST and SPT, age was the only variable significantly related to the development of other neoplasms. However, the potential non-random association and causal relationship between GISTs and SPTs remain to be investigated.
KeywordsGastrointestinal stromal tumors Associated neoplasms Synchronous malignancies Secondary primary tumors Overview of systematic reviews
Mauro Podda: Study conception and design, literature search, acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Giulia Ferraro: Study conception and design, literature search, acquisition, interpretation, and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Salomone Di Saverio: Interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published. Alessandro Cois: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Oreste Nardello: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Gaetano Poillucci: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Marco Vito Marino: Interpretation and analysis of data; critically revising the article for important intellectual content; and final approval of the version to be published. Adolfo Pisanu: Study conception and design, literature search, interpretation and analysis of data; drafting and critically revising the article for important intellectual content; and final approval of the version to be published.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors
Compliance with Ethical Standards
Conflicts of Interest
The authors declare that they have no conflict of interest.
All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was conducted after the approval of the Institutional Ethics Review Board of the Azienda Ospedaliero-Universitaria di Cagliari, Cagliari University Hospital “D. Casula,” Cagliari, Italy.
An informed consent for enabling the sharing of research data was obtained from all individual patients included in the study.
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