P-030 - Treatment of GIST: a single center experience In Constantine, Algeria

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Anti-Cancer Agents & Biologic Therapy
GIST
Presenter A. Bensalem
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors A. Bensalem
  • Medicine Faculty, Constantine/DZ

Abstract

Introduction

GIST are mesenchymal tumors that usually occur in the stomach and small bowel, rarely rectum, colon, esophagus or the mesentery. They are typically phenotype CD117 /KIT positive (95%), CD34 positive (70%). The diagnosis is confirmed by biopsy and especially by immuno-histochemical analysis. Interest of the computed tomography scan in the diagnosis and evaluation of response. Metastases are mostly intra-abdominal, peritoneal and hepatic. Surgery is the only potentially curative treatment. Tyrosine kinase inhibitors have shown efficacy in recurrent aggressive tumors and metastatic ones.

Aim of the study: to evaluate the demographic characteristics, diagnostic and therapeutic methods of GIST.

Methods

Retrospective study of 22 cases of GIST recruited for medical oncology department of the University of Constantine from January 2007 to December 2011

Results

22 cases of GIST are recruited, female predominance with a sex ratio of 1.7. The extreme age range between 17 and 81 years with a mean age of 50 years. The most common site was stomach (36%), followed by the small intestine and mesentery, each one (23%). The period of evolution is less than one year in 80% of cases. The symptoms are dominated by abdominal pain (2/3 of cases). Computed tomography scans of the abdomen and pelvis was performed in 20 patients always positive; only 02 patients were operated in the emergency setting. 85% of CT images correspond to the per operative findings; almost half of the patients were metastatic at the time of diagnosis. Surgery was the main therapeutic arm, followed by inhibitors of tyrosine kinase (TKI), CD 117 was positive in 88% of cases. A post operative recurrence was found in 64% cases after 06 months of treatment with imatinib and was treated by sunitinib. 36% of patients responded to imatinib. 18% increased after 12 months of treatment and were put up in sunitinib. 22 patients treated with imatinib : 15 progressed during the treatment and 01 patient after treatment, all requiring treatment with sunitinib, well tolerated after 09 months, 05 months and 03 months of treatment respectively.

Conclusion

The therapeutic management of GIST remains a difficult challenge. Surgery is the standard treatment; the contribution of TKI has significantly changed the prognosis of GIST with other molecules. For better management we must have an early diagnosis, repeated imaging control during chemotherapy treatments for early detection of recurrences.