Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Outcomes of Patients with Gastrointestinal Stromal Tumors in the Past Decad

Ayrton Bangolo
* ORCID logo ,
Pierre Fwelo
,
Tha’er Al-Qatish
,
John Bukasa-Kakamba
,
Tiffany Lee
,
Akira G. Cayago
,
Sarah Potiguara
,
Vignesh K. Nagesh
,
Jessica Kawall
,
Rashid Ahmed
,
Muhammad Asjad Abbas
,
Narissa Nursjamsi
,
Stacy H. Lee
,
Shagi Meti
,
Georgemar V. Arana
,
Chrishanti A. Joseph
,
Abdifitah Mohamed
,
Arthur Alencar
,
Huzaifa G. Hassan
,
Pramanu Aryal
,
Aleena Javed
,
Maksim Kalinin
,
Gbenga Lawal
,
Ibtihal Y. Khalaf
,
Midhun Mathew
,
Praveena Karamthoti
,
Bhavna Gupta
,
Simcha Weissman
Version 1 : Received: 4 July 2023 / Approved: 4 July 2023 / Online: 4 July 2023 (10:23:16 CEST)

A peer-reviewed article of this Preprint also exists.

Bangolo, A.; Fwelo, P.; Al-Qatish, T.; Bukasa-Kakamba, J.; Lee, T.; Cayago, A.G.; Potiguara, S.; Nagesh, V.K.; Kawall, J.; Ahmed, R.; Asjad Abbas, M.; Nursjamsi, N.; Lee, S.H.; Meti, S.; Arana, G.V.; Joseph, C.A.; Mohamed, A.; Alencar, A.; Hassan, H.G.; Aryal, P.; Javed, A.; Kalinin, M.; Lawal, G.; Khalaf, I.Y.; Mathew, M.; Karamthoti, P.; Gupta, B.; Weissman, S. Outcomes of Patients with Gastrointestinal Stromal Tumors in the Past Decade. Med. Sci. 2023, 11, 54. Bangolo, A.; Fwelo, P.; Al-Qatish, T.; Bukasa-Kakamba, J.; Lee, T.; Cayago, A.G.; Potiguara, S.; Nagesh, V.K.; Kawall, J.; Ahmed, R.; Asjad Abbas, M.; Nursjamsi, N.; Lee, S.H.; Meti, S.; Arana, G.V.; Joseph, C.A.; Mohamed, A.; Alencar, A.; Hassan, H.G.; Aryal, P.; Javed, A.; Kalinin, M.; Lawal, G.; Khalaf, I.Y.; Mathew, M.; Karamthoti, P.; Gupta, B.; Weissman, S. Outcomes of Patients with Gastrointestinal Stromal Tumors in the Past Decade. Med. Sci. 2023, 11, 54.

Abstract

Background: Gastrointestinal stromal tumors (GIST) are rare mesenchymal neoplasms of the gastrointestinal tract (GIT) that represent approximately 1 to 2 percent of primary gastrointestinal (GI) cancers. Owing to their rarity, very little is known about the overall epidemiology and prognostic factors of the pathology. The purpose of this study is to investigate the clinical characteristics, survival outcomes, and independent prognostic factors of patients with GIST in the past decade. Methods: A total of 2,374 patients diagnosed with GIST, between 2010 and 2017, were ultimately enrolled in our study by retrieving the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed demographics, clinical characteristics, and overall mortality (OM) as well as cancer-specific mortality (CSM) of GIST. Variables with a p value < 0.01 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) of greater than 1 representing adverse prognostic factors. Results: Multivariate cox proportional hazard regression analyses of factors affecting all-cause mortality and GIST related mortality among US patients between 2010 and 2017 revealed higher overall mortality in Non-Hispanic Blacks (HR= 1.516, 95% CI 1.172-1.961, p= 0.002), age 80+ (HR= 9.783, 95% CI4.185-22.868, p= 0), followed by age 60-79 (HR= 3.408, 95% CI 1.488-7.807, p=0.004); male patients (HR= 1.795 , 95% CI 1.461-2.206, p=0); advanced disease with distant metastasis (HR= 3.865 , 95% CI 2.977-5.019, p=0), followed by regional involvement by both direct extension and lymph node involvement (HR= 3.853, 95% CI 1.551-9.57, p=0.004); and widowed patients (HR= 1.975, 95% CI 1.494-2.61, p= 0), followed by single patients (HR= 1.53, 95% CI 1.154-2.028, p=0.003). The highest CSM was observed in the same groups, except widowed patients and patients aged 60-79. The highest CSM was also observed among patients that underwent chemotherapy (HR= 1.687, 95% CI 1.19-2.392, p= 0.003). Conclusion: In this United States population-based retrospective cohort study using the SEER database, we found that non-Hispanic blacks, male patients, and patients older than 60 years have a higher mortality with GIST. Furthermore, patients who received chemotherapy have a higher GIST specific mortality and married patients had a lower mortality. However, we do not know to what extent these independent prognostic factors interact with each other to influence mortality. This study paves the way for future studies addressing those interactions. The results of this study may help treating clinicians to identify patient populations associated with dismal prognosis as those may require closer follow-up and more intensive therapy; furthermore, with married patients having a better survival, we hope to encourage clinicians to involve family members of the affected patients early in the disease course as the social support might impact the prognosis.

Keywords

GIST; GI neurotransmitter; Pacemaker; SEER database; Clinical characteristics; Mortality

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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