Purpose: Like other malignancies, GI stromal tumors (GIST) are highly heterogeneous. This not only applies to histologic features and malignant potential, but also to geographic incidence rates. Several studies have reported GIST incidence and prevalence in Europe and North America. In contrast, GIST incidence rates in South America are largely unknown, and only a few studies have reported GIST prevalence in Latin America. Patients and Methods: Our study was part of a collaborative effort between Chile and Mexico, called Salud con Datos. We sought to determine GIST prevalence and patients' clinical characteristics, including survival rates, through retrospective analysis. Results: Overall, 624 patients were included in our study. Our results found significant differences between Mexican and Chilean registries, such as stage at diagnosis, primary tumor location, CD117-positive immunohistochemistry status, mitotic index, and tumor size. Overall survival (OS) times for Chilean and Mexican patients with GIST were 134 and 156 months, respectively. No statistically significant differences in OS were detected by sex, age, stage at diagnosis, or recurrence status in both cohorts. As expected, patients categorized as being at high risk of recurrence displayed a trend toward poorer progression-free survival in both registries. Conclusion: To the best of our knowledge, this is the largest report from Latin America assessing the prevalence, clinical characteristics, postsurgery risk of recurrence, and outcomes of patients with GIST. Our data confirm surgery as the standard treatment of localized disease and confirm a poorer prognosis in patients with regional or distant disease. Finally, observed differences between registries could be a result of registration bias.
Bibliographical noteFunding Information:
This study included clinical data from a total of 624 patients with GIST; 521 patients were contributed by the Fundación GIST Mexico and 103 by Fundación GIST Chile. This joint work is the result of the Salud con Datos initiative, which was initially formed by both advocacy groups as part of Alianza GIST, a Latin American nonprofit organization focused on the development of research, public policies, and improved access to specific treatments for Latin American patients with GIST. The registry was funded by the Life Raft Group, an international, nonprofit patient advocacy organization created to enhance survival and quality of life for people living with GIST through patient-powered research, education, and empowerment and global advocacy efforts. Life Raft Group had no access to patient raw data and did not participate in the database setup, data acquisition, or analysis during this study. This study was designed as an observational, multicenter, retrospective registry and was approved by the institutional review board and ethics committee of all participating institutions, following the Declaration of Helsinki, Good Clinical Practices, and both Mexican and Chilean regulations. Written informed consent was obtained from all participating patients.
Copyright © 2020 American Society of Clinical Oncology.
- Gastrointestinal stromal tumors
- Neoplasm recurrence