Difference between revisions of "Gastrointestinal stromal tumor natural history"

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(Complications)
 
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*Volvulus
 
*Volvulus
 
*Intussusception
 
*Intussusception
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*Surgical complications associated with resection include:
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**Atelectasis
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**Pneumonia
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**Urinary tract infection
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**Abscess formation
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**Small-bowel obstruction
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**Deep venous thrombosis
  
 
==Prognosis==
 
==Prognosis==

Latest revision as of 22:01, 7 December 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Gastrointestinal stromal tumor Microchapters

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Overview

Most common site of involvement of GIST is stomach(70%).

Natural history

Common sites of involvement include:

GISTs occur not only anywhere along the gastrointestinal tract, but also in the mesentery, omentum and retroperitoneum, which is called extra-gastrointestinal GISTs. Metastatic lesions may also be seen in cases of malignant extra-gastrointestinal GISTs

Complications

  • Gastrointestinal bleeding
  • Bowel obstruction
  • Bowel perforation
  • Peritonitis
  • Volvulus
  • Intussusception
  • Surgical complications associated with resection include:
    • Atelectasis
    • Pneumonia
    • Urinary tract infection
    • Abscess formation
    • Small-bowel obstruction
    • Deep venous thrombosis

Prognosis

At the time of clinical presentation, the prognosis appears to be influenced by genetic events other than kinase mutations, although a particular kinase mutation may help to define the initial clinical course of a GIST. Based on retrospective studies from time periods that predated the clinical use of kinase inhibitors, current recommendations for assessing the risk of progression for a newly diagnosed primary GIST rely on three parameters:

  • Mitotic index (mitoses per 50 high-power fields)
  • Tumor size
  • Tumor location[1]



  • Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary.
  • Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor.
    • Patients with gastric GIST have been reported to have better outlook as compared to patients with extragastric GIST.
    • Patients with localized primary disease have a average survival period of 5 years.
    • Patients with malignant lesions and metastasis have an average survival period of 1-2 years.
    • Patients with mitotic rate of >10 per 50 HPF have an average survival period of 1.5-2 years
    • Patients with mitotic rate <10 per HPF have an average survival period of 8 years.



'However, the prognosis is generally regarded as poor/good/excellent.

  • The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
  • [Subtype of disease/malignancy] is associated with the most favorable prognosis.
  • The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.

Refrences


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