Gastrointestinal stromal tumours in patients presenting to an academic hospital in South Africa

Abstract

Background: Published information on African patients with gastrointestinal stromal tumours (GISTs) is limited. Aim: The aim of this study was to review patient and tumour characteristics, and treatment, for a cohort of African patients and compare findings to studies from other centres. Setting: Groote Schuur Hospital, South Africa. Methods: Data were collected on all patients referred to Groote Schuur Hospital (GSH) during the period October 2003 to November 2019, including demographics, tumour characteristics and treatment outcomes. Results: There were 124 patients in total. There was a slight male predominance (55.6%) and the median age was 56 years. The most common primary tumour sites were the stomach (66.2%) and small bowel (21.8%) with a median primary tumour diameter of 95.5 mm. Mutational analysis was conducted for 39 patients with 66.7% of these patients having mutations in KIT exon 11. The primary tumour was resected in 72 patients, with 48.6% having high-risk tumours according to the National Institutes of Health (NIH) risk assessment. The 10-year overall survival (OS) values for patients by risk group were 83% (very low and low risk), 73% (intermediate risk) and 66% (high risk). The disease control rate for patients treated with imatinib was 84.6%. The median progression-free survival (PFS) for patients treated with imatinib for palliation was 23 months with OS of 31 months. Conclusion: In contrast to patients from other centres, our patients were younger and had larger tumours. Contribution: The distribution of primary tumour site, mutational analysis and response to imatinib was consistent with the literature.

Keywords

• gastrointestinal stromal tumours
• africa
• treatment
• imatinib
• mutations
• survival