Original Research

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

Barbara M. Robertson, Galya E. Chinnery, Michael L. Locketz, Michelle Parker, Alvera A. Vorster, Raj Ramesar, Eugenio Panieri, Alistair J. Hunter
South African Journal of Oncology | Vol 7 | a265 | DOI: https://doi.org/10.4102/sajo.v7i0.265 | © 2023 Barbara M. Robertson, Galya E. Chinnery, Michael L. Locketz, Michelle Parker, Alvera A. Vorster, Raj Ramesar, Eugenio Panieri, Alistair J. Hunter | This work is licensed under CC Attribution 4.0
Submitted: 06 January 2023 | Published: 13 June 2023

About the author(s)

Barbara M. Robertson, Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Galya E. Chinnery, Department of Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Michael L. Locketz, Division of Anatomical Pathology, National Health Laboratory Service, University of Cape Town, Cape Town, South Africa
Michelle Parker, Department of Human Biology, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Alvera A. Vorster, South African Medical Research Council, Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
Raj Ramesar, South African Medical Research Council, Genomic and Precision Medicine Research Unit, Division of Human Genetics, Department of Pathology, University of Cape Town, Cape Town, South Africa
Eugenio Panieri, Department of Surgery, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa
Alistair J. Hunter, Department of Radiation Oncology, Groote Schuur Hospital and University of Cape Town, Cape Town, 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

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