Recent findings from a population-based retrospective cohort study at the at Moores Cancer Center at UC San Diego Health, led by senior author, Jason Sicklick, MD, indicate that small intestine tumors in adolescents and young adults with Gastrointestinal Stromal Tumor (GIST) were associated with improved survival when compared to stomach tumors.
This is a surprising result when compared with data from older patients. According to Katherine Fero, lead author of the study, “Many earlier studies including one from our group have shown that stomach GISTs have a better prognosis when we look at all patients with GIST. Thus, there is something biologically unique about GISTs in younger patients.”
Participants in the study included 393 AYA patients (ages 13 to 39), and 5373 older adult patients (OA) from the Surveillance, Epidemiology and End Result (SEER) database who were diagnosed with GISTs histologically from January 1, 2001 through December 31, 2013, with follow-up through December 31, 2015.
Findings indicate that AYA patients are more likely to undergo surgical management than OA patients, and that operative management is associated with improved overall survival and GIST-specific survival.
Of the 392 AYA patients with GISTs, 332 (84.7%) were managed operatively. The 5-year Gist-specific survival rate (GSS) was 83.3% for AYA patients, and 75.4% for OA patients. The 5-year overall survival rate (OS) was 82.4% for AYA patients, and 67.1% for OA patients.
Non-operative management of AYA patients was associated with a 127% increased risk of GIST-specific death. These groups are more likely to be treated surgically than OA. In a subset analysis of the role of resection of metastatic GIST, the 5-year OS and the 5-year GSS appeared to be superior in AYA patients compared with the OA patients.
The study fills a necessary gap in population-based evidence around understanding of risk factors to long-term outcomes of GIST among AYA patients and demonstrates the possibility of a distinct disease biology. It will be important to evaluate both this and other studies to develop consensus as to the surgical management of these young patients and its impact on their quality of life.
Access the study here.