Gastro-intestinal stromal tumours (GISTs) – the Pretoria experience and a literature review

Abstract

Aim. To analyse the presentation and management of patients with gastro-intestinal stromal tumours (GISTs) at Pretoria hospitals. Design. A retrospective study was done in which all available clinical records of primary c-KIT positive GISTs were analysed. Setting. Secondary and tertiary care institutions in Pretoria, including both private and public hospitals. Subjects. The population studied included all individuals treated at Pretoria hospitals from 17 July 2000 to 1 April 2009 who had a GIST confirmed with immunohistochemical c‑KIT staining. Patients with incomplete or inaccessible clinical records were excluded. Outcome measures. Patient demographics including gender, age and race; presenting symptoms and signs; results of special investigations; and treatment. Results. Fifty-four cases were identified for inclusion in the study. The age of the subjects ranged from 15 to 83 years. The male-to-female ratio was 1.5:1. The organ most commonly affected was the stomach, and abdominal pain and weight loss were the most common presenting symptoms. Seventy-six per cent of the patients were treated surgically, and 24% received imatinib. Conclusion. GISTs often present late with nonspecific symptoms, and are frequently discovered incidentally. Large tumours tend to be malignant.