Additional primary malignancies in patients with gastrointestinal stromal tumor (GIST): A clinicopathologic study of 260 patients with molecular analysis and review of the literature Journal Article

   

Authors:	Hechtman, J. F.; DeMatteo, R.; Nafa, K.; Chi, P.; Arcila, M. E.; Dogan, S.; Oultache, A.; Chen, W.; Hameed, M.
Article Title:	Additional primary malignancies in patients with gastrointestinal stromal tumor (GIST): A clinicopathologic study of 260 patients with molecular analysis and review of the literature
Abstract:	Background: The incidence of other primary neoplasms in gastrointestinal stromal tumor (GIST) patients is relatively high. Our aim was to better characterize the clinicopathologic and molecular relationships in a cohort of GIST patients. Methods: All GIST patients with tumor samples sent for molecular testing were identified via electronic medical records. Clinicopathologic characteristics of GIST and additional primary malignancies were analyzed. Results: Of 260 patients, 50 (19 %) had at least one additional primary malignancy. In 33 patients, separate primary neoplasms predated their GIST diagnosis and most commonly included: prostate (n = 9), breast (n = 8), and hematologic (n = 5). Renal (n = 4) and hematologic (n = 3) malignancies were the most frequent cancers identified after GIST diagnosis. The majority (8 of 12, 66 %) of malignancies diagnosed after GIST were found incidentally. Patients who developed other malignancies after GIST more often had KIT exon 11 mutations (100 vs. 66 %, P = 0.01). In comparison to patients with only GIST, patients with a second primary neoplasm of any chronology had GISTs with increased mitotic rate (≥5 per 50 high-power fields) (P = 0.0006). Literature review revealed colorectal cancer, gastric, prostate, renal, leukemia, and desmoid-type fibromatosis as the most common secondary neoplasms. Conclusions: Nineteen percent of GIST patients develop other malignancies. This is the first report to describe a relationship between additional primary malignancy and both mutation and mitotic rate of GIST. Although the basis of these relationships remains to be investigated, caution in the clinical management of GIST patients with additional lesions is warranted. © 2015, Society of Surgical Oncology.
Keywords:	adult; human tissue; aged; leukemia; gene mutation; major clinical study; overall survival; exon; histopathology; cancer localization; cancer incidence; colorectal cancer; gastrointestinal stromal tumor; imatinib; platelet derived growth factor alpha receptor; breast cancer; cohort analysis; prostate cancer; prostate; hematologic malignancy; clinical evaluation; stomach cancer; mitosis rate; incidental finding; second cancer; kidney cancer; molecular biology; multiple cancer; esophagus tumor; oncogene c kit; fibromatosis; small intestine tumor; human; male; female; article; clinicopathologic study; kit exon 11
Journal Title:	Annals of Surgical Oncology
Volume:	22
Issue:	8
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2015-08-01
Start Page:	2633
End Page:	2639
Language:	English
DOI:	10.1245/s10434-014-4332-z
PROVIDER:	scopus
PMCID:	PMC4508237
PUBMED:	25564173
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84938289262&partnerID=40&md5=a9e2b0a80a24d9c5600629265301260e
Notes:	Export Date: 2 September 2015 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/79656