Gastrointestinal stromal tumor natural history: Difference between revisions
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==Overview== | ==Overview== | ||
If left untreated, patients with gastrointestinal stromal tumors (GIST) may progress to develop abdominal pain, abdominal distension and perforation. A benign GIST may remain unchanged for years before its progression into malignancy. A GIST may rupture and lead to intra-abdominal or gastrointestinal bleeding. Ultimately, the GIST may metastasize and turn fatal. Common complications of GIST include [[bowel obstruction]], [[bowel perforation]], and [[peritonitis]]. Depending on the extent of the tumor at the time of diagnosis, the prognosis of GIST may vary. Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor. A benign GIST treated with surgical resection has much more better outcome as compared to patients with malignant GIST. | If left untreated, patients with gastrointestinal stromal tumors (GIST) may progress to develop [[abdominal pain]], [[abdominal distension]] and [[perforation]]. A benign GIST may remain unchanged for years before its progression into [[malignancy]]. A GIST may [[rupture]] and lead to intra-abdominal or [[Gastrointestinal Bleeding|gastrointestinal bleeding]]. Ultimately, the GIST may [[metastasize]] and turn fatal. Common complications of GIST include [[bowel obstruction]], [[bowel perforation]], and [[peritonitis]]. Depending on the extent of the [[tumor]] at the time of diagnosis, the prognosis of GIST may vary. Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor. A benign GIST treated with surgical resection has much more better outcome as compared to patients with [[malignant]] GIST. | ||
==Natural history== | ==Natural history== | ||
*Around 75% patients of gastrointestinal stromal tumors (GIST) are asymptomatic and are diagnosed as an incidental finding on imaging studies done for other reasons. | *Around 75% patients of gastrointestinal stromal tumors (GIST) are [[asymptomatic]] and are diagnosed as an [[incidental finding]] on [[imaging studies]] done for other reasons. | ||
*If left untreated, patients with GIST may progress to develop abdominal pain, abdominal distension and perforation. | *If left untreated, patients with GIST may progress to develop [[abdominal pain]], [[abdominal distension]] and [[perforation]]. | ||
*Depending upon the type of GIST (benign or malignant), a benign GIST may remain unchanged for years before its progression into malignancy.<ref name="pmid24707244">{{cite journal |vauthors=Antonopoulos P, Leonardou P, Barbagiannis N, Alexiou K, Demonakou M, Economou N |title=Gastrointestinal and extragastrointestinal stromal tumors: report of two cases and review of the literature |journal=Case Rep Gastroenterol |volume=8 |issue=1 |pages=61–6 |year=2014 |pmid=24707244 |pmc=3975174 |doi=10.1159/000354724 |url=}}</ref> | *Depending upon the type of GIST ([[benign]] or [[malignant]]), a [[benign]] GIST may remain unchanged for years before its progression into [[malignancy]].<ref name="pmid24707244">{{cite journal |vauthors=Antonopoulos P, Leonardou P, Barbagiannis N, Alexiou K, Demonakou M, Economou N |title=Gastrointestinal and extragastrointestinal stromal tumors: report of two cases and review of the literature |journal=Case Rep Gastroenterol |volume=8 |issue=1 |pages=61–6 |year=2014 |pmid=24707244 |pmc=3975174 |doi=10.1159/000354724 |url=}}</ref> | ||
*GIST are highly vascular and an untreated tumor may attain massive size leading to rupture and intra-abdominal or gastrointestinal bleeding. | *GIST are highly [[vascular]] and an untreated [[tumor]] may attain massive size leading to [[rupture]] and intra-abdominal or [[gastrointestinal bleeding]]. | ||
*A ruptured GIST may lead to coffee ground emesis, black stools or even malena. | *A ruptured GIST may lead to coffee ground emesis, black stools or even malena. | ||
*Ultimately, the GIST may metastasize and turn fatal. | *Ultimately, the GIST may metastasize and turn fatal. | ||
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==Prognosis== | ==Prognosis== | ||
*Depending on the extent of the tumor at the time of diagnosis, the prognosis of GIST may vary.<ref>{{Cite web | title =Risk Assessment and Prognosis | *Depending on the extent of the [[tumor]] at the time of diagnosis, the prognosis of GIST may vary.<ref>{{Cite web | title =Risk Assessment and Prognosis | ||
| url =http://www.cancer.gov/types/soft-tissue-sarcoma/hp/gist-treatment-pdq#section/_1 }}</ref> | | url =http://www.cancer.gov/types/soft-tissue-sarcoma/hp/gist-treatment-pdq#section/_1 }}</ref> | ||
*Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor (mitoses per 50 high-power fields). | *Prognosis of GIST depends upon size, location, spread and mitotic rate of the [[tumor]] (mitoses per 50 high-power fields). | ||
**Patients with gastric GIST have been reported to have better outlook as compared to patients with extragastric GIST. | **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 localized primary disease have a average survival period of 5 years. | ||
Revision as of 20:14, 15 December 2017
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Gastrointestinal stromal tumor Microchapters |
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Differentiating Gastrointestinal stromal tumor from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Gastrointestinal stromal tumor natural history On the Web |
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American Roentgen Ray Society Images of Gastrointestinal stromal tumor natural history |
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Directions to Hospitals Treating Gastrointestinal stromal tumor |
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Risk calculators and risk factors for Gastrointestinal stromal tumor natural history |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
If left untreated, patients with gastrointestinal stromal tumors (GIST) may progress to develop abdominal pain, abdominal distension and perforation. A benign GIST may remain unchanged for years before its progression into malignancy. A GIST may rupture and lead to intra-abdominal or gastrointestinal bleeding. Ultimately, the GIST may metastasize and turn fatal. Common complications of GIST include bowel obstruction, bowel perforation, and peritonitis. Depending on the extent of the tumor at the time of diagnosis, the prognosis of GIST may vary. Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor. A benign GIST treated with surgical resection has much more better outcome as compared to patients with malignant GIST.
Natural history
- Around 75% patients of gastrointestinal stromal tumors (GIST) are asymptomatic and are diagnosed as an incidental finding on imaging studies done for other reasons.
- If left untreated, patients with GIST may progress to develop abdominal pain, abdominal distension and perforation.
- Depending upon the type of GIST (benign or malignant), a benign GIST may remain unchanged for years before its progression into malignancy.[1]
- GIST are highly vascular and an untreated tumor may attain massive size leading to rupture and intra-abdominal or gastrointestinal bleeding.
- A ruptured GIST may lead to coffee ground emesis, black stools or even malena.
- Ultimately, the GIST may metastasize and turn fatal.
Complications
Common complications of GIST include:
- Gastrointestinal bleeding
- Bowel obstruction
- Bowel perforation
- Peritonitis
- Volvulus
- Intussusception
- Surgical complications associated with resection include:
Prognosis
- Depending on the extent of the tumor at the time of diagnosis, the prognosis of GIST may vary.[2]
- Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor (mitoses per 50 high-power fields).
- 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.
Refrences
- ↑ Antonopoulos P, Leonardou P, Barbagiannis N, Alexiou K, Demonakou M, Economou N (2014). "Gastrointestinal and extragastrointestinal stromal tumors: report of two cases and review of the literature". Case Rep Gastroenterol. 8 (1): 61–6. doi:10.1159/000354724. PMC 3975174. PMID 24707244.
- ↑ "Risk Assessment and Prognosis".