Locoregional Treatments for Metastatic Gastrointestinal Stromal Tumor in British Columbia: A Retrospective Cohort Study from January 2008 to December 2017
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methodology
2.1. Study Subjects
2.2. Data Collection and Analysis
2.3. Statistical Analysis
2.4. Ethics
3. Results
3.1. Cohort Characteristics
3.2. Surgery
3.3. Radiotherapy (RT)
3.4. Local Ablation
3.5. Survival Outcome
4. Discussions
4.1. Surgery
4.2. Radiotherapy (RT)
4.3. Local Ablation
4.4. Study Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Patient Characteristics | Rec Met w/o LRT (%) n = 55 | Rec Met with LRT (%) n = 20 | De Novo Met w/o LRT (%) n = 26 | De Novo Met with LRT (%) n = 26 | |
---|---|---|---|---|---|
Age Median (min–max) | 66 (31–84) | 66 (31–75) | 67.5 (23–90) | 63 (36–82) | |
Gender Female Male | 21 (38.2%) 34 (61.8%) | 9 (45%) 11 (55%) | 15 (57.7%) 11 (42.3%) | 8 (30.8%) 18 (69.2%) | |
Treatment Center Vancouver Fraser Valley Victoria Interior Northern Community/unknown | 18 (32.7%) 18 (32.7%) 10 (18.2%) 7 (12.7%) 1 (1.8%) 1 (1.8%) | 12 (60%) 2 (10%) 1 (5%) 4 (20%) 1 (5%) 0 (0%) | 17 (65.4%) 4 (15.4%) 2 (7.7%) 3 (11.5%) 0 (0%) 0 (0%) | 7 (26.9%) 9 (34.6%) 4 (15.4%) 5 (19.2%) 1 (3.8%) 0 (0%) | |
Primary Tumour Characteristics | Tumour Size (cm) >2 ≥2 and ≤5 >5 and ≤10 10 | 1 (1.8%) 9 (16.4%) 16 (29.1%) 29 (52.7%) | 0 (0%) 4 (20%) 8 (40%) 8 (40%) | 1 (3.8%) 2 (7.7%) 8 (30.8%) 15 (57.7%) | 0 (0%) 5 (19.2%) 14 (53.8%) 7 (26.9%) |
Mitotic Rate (/50HPF) <5 ≥5 and ≤10 >10 Unreported/unknown | 16 (29.1%) 11 (20%) 23 (41.8%) 5 (9.1%) | 3 (15%) 7 (35%) 10 (50%) 0 (0%) | 10 (38.5%) 3 (11.5%) 5 (19.2%) 8 (30.8%) | 7 (26.9%) 3 (11.5%) 12 (46.2%) 4 (15.4%) | |
Tumour Location Stomach Small Bowel Rectum/Pelvis Other | 23 (41.8%) 26 (47.3%) 3 (5.5%) 3 (5.6%) | 5 (25%) 6 (30%) 6 (30%) 3 (15%) | 7 (26.9%) 4 (15.4%) 4 (15.4%) 11 (42.3%) | 7 (26.9%) 15 (57.7%) 1 (3.8%) 3 (11.6%) | |
Tumour Rupture No Yes | 49 (89.1%) 6 (10.9%) | 19 (95%) 1 (5%) | 26 (100%) 0 (0%) | 22 (84.6%) 4 (15.4%) | |
Mutational Status KIT Exon 11 KIT Exon 9 Wt PDGFRA Exon 18 D842V PDGFRA Exon 12 KIT Exon 9 and Exon 11 KIT Exon 11 and Exon 13 KIT Exon 11 and SDHA Unknown/failed | n = 41 (ordered) 20 (48.8%) 7 (17.1%) 7 (17.1%) 2 (4.9%) 1 (2.4%) 1 (2.4%) 1 (2.4%) 0 (0%) 2 (4.9%) | n = 16 (ordered) 11 (68.7%) 2 (12.5%) 3 (18.8%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) | n = 15 (ordered) 8 (53.3%) 0 (0%) 3 (20.0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (6.7%) 3 (20.0%) | n = 17 (ordered) 13 (76.4%) 1 (5.9%) 2 (11.8%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 1 (5.9%) | |
Systemic treatment median (range) | 1 (1–4) | 2 (1–5) | 2 (1–5) | 1 (1–4) |
Patient Characteristics | Primary Tumour Characteristics | Treatment Characteristics and Outcome | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Patient ID | Age at Metastatic Diagnosis | Gender | Recurrence/De Novo | Size (cm) | Location | Mitotic Count (/50HPF) | Tumor Rupture (Yes/No) | Systemic Treatment * | Reason for RT | Clinical Outcome |
22 | 79 | Male | Recurrence | 10.5 | Stomach | 5 | No | I, S 1 | Bleeding | SI |
27 | 59 | Female | Recurrence | 7 | Rectum | >10 | No | I, S, R, C 1, Ri, | Pain | NSI |
38 | 71 | Female | de novo | 5 | Stomach | 10–15 | No | I 1, S | Bleeding | SI |
89 | 63 | Male | de novo | 3.7 | Stomach | 150 | No | I, S 1 | Preventative bleeding ** | SI |
97 | 67 | Male | Recurrence | 6.3 | Rectum | 20 | No | I ¹ | Local control for progressive bone disease | SD for 6 months |
99 | 57 | Male | Recurrence | 16.9 | Rectum | 100 | No | I (Adjuvant) I 1, R, S | Pseudo-adjuvant RT after metastectomy | Local control not achieved |
106 | 72 | Female | de novo | 9.2 | Small bowel | Not reported | No | I, S 1 | Pain | SI |
143 | 73 | Female | Recurrence | 5.1 | Large bowel | 3–4 | No | I (Adjuvant) I 1, S | Pain | SI |
149 | 78 | Female | Recurrence | 8.5 | Rectum | 50 | No | I (Neoadjuvant) S 1 | Pain | SI |
269 | 76 | Male | Recurrence | 14 | Stomach | 10 | No | I (Adjuvant) I 1, S, R, I, A | Bleeding | SI |
358 | 63 | Male | Recurrence | 18 | Small bowel | 100 | No | I (Neoadjuvant) I 1, R, A 1 | Pain | SI |
414 | 36 | Male | Recurrence | 5.5 | Small bowel | 30 | No | I, S, R, N, | Local control for progressive visceral disease | Local control not achieved |
Patient Characteristics | Primary Tumour Characteristics | Treatment Characteristics | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Patient ID | Age at Metastatic Diagnosis | Gender | Reccurence/De Novo | Size (cm) | Location | Mitotic Count (/50HPF) | Tumour rupture (Yes/No) | Systemic Treatment * | Reason for Ablation | Best Response | Duration of Response |
185 | 80 | Female | Recurrence | 4 | Small bowel | <5 | No | I ¹ | MWA–2 liver lesions | PR | 17 mos |
214 | 48 | Male | de novo | 9.5 | Small bowel | <5 | No | I (Neoadjuvant) I 1, S, R, I | RFA–1 liver lesion | PR | 12 mos |
413 | 57 | Female | Recurrence | 7 | Stomach | 12–16 | No | I 1, S, So, I | RFA–2 liver lesions | PR | 1 mos |
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Patterson, T.; Li, H.; Chai, J.; Debruyns, A.; Simmons, C.; Hart, J.; Pollock, P.; Holloway, C.L.; Truong, P.T.; Feng, X. Locoregional Treatments for Metastatic Gastrointestinal Stromal Tumor in British Columbia: A Retrospective Cohort Study from January 2008 to December 2017. Cancers 2022, 14, 1477. https://doi.org/10.3390/cancers14061477
Patterson T, Li H, Chai J, Debruyns A, Simmons C, Hart J, Pollock P, Holloway CL, Truong PT, Feng X. Locoregional Treatments for Metastatic Gastrointestinal Stromal Tumor in British Columbia: A Retrospective Cohort Study from January 2008 to December 2017. Cancers. 2022; 14(6):1477. https://doi.org/10.3390/cancers14061477
Chicago/Turabian StylePatterson, Tiffany, Haocheng Li, Jocelyn Chai, Angeline Debruyns, Christine Simmons, Jason Hart, Phil Pollock, Caroline L. Holloway, Pauline T. Truong, and Xiaolan Feng. 2022. "Locoregional Treatments for Metastatic Gastrointestinal Stromal Tumor in British Columbia: A Retrospective Cohort Study from January 2008 to December 2017" Cancers 14, no. 6: 1477. https://doi.org/10.3390/cancers14061477