Localized gastrointestinal stromal tumor of the rectum: An uncommon primary site with prominent disease and treatment-related morbidities

Farid,Mohamad; Lee,Marcus  Jin Fu; Chew,Min   Hoe; Ong,Whee  Sze; Sairi,Alisa  Noor Hidayah; Foo,Kian  Fong; Choo,Su  Pin; Koo,Wen  Hsin; Ong,Simon; Koh,Poh  Koon; Quek,Richard

doi:10.3892/mco.2012.25

January-February 2013 Volume 1 Issue 1

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January-February 2013 Volume 1 Issue 1

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Article

Localized gastrointestinal stromal tumor of the rectum: An uncommon primary site with prominent disease and treatment-related morbidities

Authors:
- Mohamad Farid
- Marcus Jin Fu Lee
- Min Hoe Chew
- Whee Sze Ong
- Alisa Noor Hidayah Sairi
- Kian Fong Foo
- Su Pin Choo
- Wen Hsin Koo
- Simon Ong
- Poh Koon Koh
- Richard Quek
View Affiliations / Copyright

Affiliations: Department of Medical Oncology, National Cancer Centre Singapore, 169610, Republic of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, 119228, Republic of Singapore, Department of Colorectal Surgery, Singapore General Hospital, 169608, Republic of Singapore, Department of Clinical Trials and Epidemiological Sciences, National Cancer Centre Singapore, 169610, Republic of Singapore, Parkway Cancer Centre, Gleneagles Hospital, 258500, Republic of Singapore
Pages: 190-194
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Published online on: September 19, 2012

https://doi.org/10.3892/mco.2012.25
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Abstract

Well‑established clinicopathological variables used in the risk stratification of gastrointestinal stromal tumor (GIST) may not completely predict rectal GIST, an uncommon and poorly studied GIST subset. The aim of the present study was to determine the patterns of relapse and morbidities associated with recurrence in rectal GIST. A single‑institution retrospective study between 2002 and 2011 was conducted, identifying 9 patients (8%) with localized rectal GIST, while comparing small intestinal (n=37) and gastric (n=63) GIST (median age, 60 years). Rectal GIST tumors were smaller compared to small intestinal/gastric GIST (P=0.044). The number of mitoses per 50 high-power field (HPF) did not differ by primary site. In general, 73% of patients were high‑risk, as defined by the National Institutes of Health (NIH) consensus criteria, however, only 25% received adjuvant imatinib. Fewer rectal GIST patients achieved negative surgical margins compared to small intestinal/gastric GIST (67 vs. 92%; P=0.054). Of the 9 patients with localized rectal GIST 6 had peri‑operative tumor rupture, anastomotic breakdown or required anal sphincter‑compromising surgery. At the time of the first relapse, 83% of the recurrences were local failures for rectal GIST, compared to 21% for small intestinal/gastric GIST (P=0.005). The median relapse‑free survival was 51 months for the entire cohort, and 54, 36 and 56 months for rectal, small intestinal and gastric GIST, respectively (P=0.468). Rectal GIST was found to be associated with high rates of local relapse and significant morbidity, despite being significantly smaller compared to GIST of other sites. A multimodality peri‑operative therapeutic approach may be required to improve outcomes.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Localized gastrointestinal stromal tumor of the rectum: An uncommon primary site with prominent disease and treatment-related morbidities

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