Epidemiology, prognostication and treatment outcome of gastrointestinal stromal tumour: A single centre prospective study


  • Neena Prasad S.
  • Suman Meyur
  • Sumana Maiti Das
  • Souvik Paul
  • Siddhartha Basu
  • Siddhartha Das




GIST, CD117, DOG1, progression free survival


Introduction and Aim: GI stromal tumours (GISTs) being most frequent mesenchymal tumours of the alimentary tract have few studies on epidemiology in this subcontinent. The current prospective study is aimed at gathering data on the molecular epidemiology and possible effect of molecular markers on standard pathological prognostic factors and also to measure the overall disease outcome.


Materials and Methods: In this prospective epidemiologic study conducted from 2016 to 2019, all GIST patients registering at the Radiotherapy Department of IPGME & R, Kolkata, India; identified by histopathology were prescribed pre-specified immune-histochemical tests and offered a protocolized treatment. The patients were followed up for a minimum of twelve months and on average for thirty months, to watch for disease progression.


Results: A total of 38 patients with median age 49.5 years with male predominance (p= 0.005) presented most commonly with abdominal pain (42.1%); jejunum (31.6%) followed by stomach (26.3%) being most common sites, spindle cell type (78.9%) being commonest histological type. Immunohistochemistry showed positive expression for SMA (7.9%), DOG1 (28.9%), CD34 (31.6%), CD117/cKIT (65.8%). CD117 positivity (Rho= -0.366, p=0.024) has negative association with mitotic count, whereas DOG1 (Rho=.513, p=0.001) and CD34 (Rho=.459, p=0.004) positivity have positive association with tumour dimension. DOG1 positivity was found to be a contributing factor of disease progression (RR 12.57, p=0.035).


Conclusion: In sub-continental patients, gender and age distribution of GISTs differ from western countries but not pathological features. Molecular markers have important prognostic significance.

Author Biographies

Neena Prasad S.

Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India

Suman Meyur

Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India

Sumana Maiti Das

Department of Radiotherapy, R G Kar Medical College, Kolkata, West Bengal, India

Souvik Paul

Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India            

Siddhartha Basu

Department of Radiotherapy, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India

Siddhartha Das

Departmentof Physiology, DHGMCH, Diamond Harbour, S-24 Parganas, West Bengal, India


Miettinen, M., Lasota, J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70-83.

Patel, N., Benipal, B. Incidence of gastrointestinal stromal tumors in the United States from 2001-2015: a United States Cancer Statistics analysis of 50 states. Cureus. 2019 Feb; 11(2): e4120.

Babaei, M. A., Kamalidehghan, B., Saleem, M., Huri, H.Z., Ahmadipour, F. Receptor tyrosine kinase (c-Kit) inhibitors: a potential therapeutic target in cancer cells. Drug Des Devel Ther. 2016;10:2443-2449.

Hirota, S., Isozaki, K., Moriyama, Y., Hashimoto, K., Nishida, T., Ishiguro, S., Kawano, K., Hanada, M., Kurata, A., Takeda, M., Muhammad Tunio, G., Matsuzawa, Y., Kanakura, Y., Shinomura, Y., Kitamura, Y. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577-580.

Espinosa, I., Lee, C. H., Kim, M. K. A novel monoclonal antibody against DOG1 is a sensitive and specific marker for gastrointestinal stromal tumors. Am J Surg Pathol. 2008; 32:210-218.

Zhang, L., Smyrk, T. C., Young Jr, W. F., Stratakis, C. A., Carney, J. A. Gastric stromal tumors in Carney triad are different clinically, pathologically, and behaviourally from sporadic gastric gastrointestinal stromal tumors: findings in 104 cases. Am J Surg Pathol. 2010; 34(1):53-64.

Fletcher, C. D., Berman, J. J., Corless, C., Gorstein, F., Lasota, J., Longley, B. J., et al., Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002;33(5):459-465.

Agaimy, A. Gastrointestinal stromal tumors (GIST) from risk stratification systems to the new TNM proposal: more questions than answers? A review emphasizing the need for a standardized GIST reporting. Int J Clin Exp Pathol. 2010;3(5):461-471.

Miettinen, M., Lasota, J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006;130:1466-1478.

Joensuu, H., Martin-Broto, J., Nishida, T. Follow-up strategies for patients with gastrointestinal stromal tumour treated with or without adjuvant imatinib after surgery. Eur J Cancer. 2015;51:1611-1617.

Schmieder, M., Henne-Bruns, D., Mayer, B., Knippschild, U., Rolke, C., Schwab, M., et al., Comparison of different risk classification systems in 558 patients with gastrointestinal stromal tumors after R0-Resection. Front Pharmacol. 2016;7:504-506.

Panizo-Santos, A., Sola, I., Vega, F., de Alava, E., Lozano, M. D., Idoate, M. A. Predicting metastatic risk of gastrointestinal stromal tumors: Role of cell proliferation and cell cycle regulatory proteins. Int J Surg Pathol. 2000;8:133-144.

Shrikhande, S. V., Sirohi, B., Barreto, S. G., Chacko, R. T., Parikh, P. M., Pautu, J., et al., Indian Council of Medical Research consensus document for the management of gastrointestinal stromal tumors. Indian J Med Paediatr Oncol. 2014;35(4):244-248.

Søreide, K., Sandvik, O. M., Søreide, J. A., Giljaca, V., Jureckova, A., Bulusu, V. R. Global epidemiology of gastrointestinal stromal tumours (GIST): a systematic review of population-based cohort studies. Cancer epidemiology. 2016;40:39-46.

Rajappa, S., Muppavarapu, K. M., Uppin, S., Digumarti, R. Gastrointestinal stromal tumors: a single institution experience of 50 cases. Indian J Gastroenterol. 2007;26(5):225-229.

Lakshmi, V. A., Chacko, R. T., Kurian, S. Gastrointestinal stromal tumors: A 7-year experience from a tertiary care hospital. Indian J Pathol Microbiol. 2010;53:628-633.

Varshney, V. K., Gupta, R. K., Saluja, S. S., Tyagi, I., Mishra, P. K., Batra, V. V. Analysis of clinicopathological and immunohistochemical parameters and correlation of outcomes in gastrointestinal stromal tumors. Indian J Cancer. 2019;56:135-143.

Cyriac, S., Rajendranath, R., Sagar, T. G. Gastrointestinal stromal tumor: Analysis of outcome and correlation with c-kit status in Indian population. Indian J Cancer. 2014;51:35-39.

Rizzo, F. M., Palmirotta, R., Marzullo, A., Resta, N., Cives, M., Tucci, M., et al., Parallelism of DOG1 expression with recurrence risk in gastrointestinal stromal tumors bearing KIT or PDGFRA mutations. BMC Cancer. 2016;16:87-88

Sahin, S., Ekinci, O., Seckin, S., Dursun, A. The diagnostic and prognostic utility of DOG1 expression on gastrointestinal stromal tumors. Turk Patoloji Derg. 2017;33(1):1-8.




How to Cite

Prasad S. N, Meyur S, Maiti Das S, Paul S, Basu S, Das S. Epidemiology, prognostication and treatment outcome of gastrointestinal stromal tumour: A single centre prospective study. Biomedicine [Internet]. 2023 Feb. 26 [cited 2024 Mar. 3];43(1):183-8. Available from: https://biomedicineonline.org/index.php/home/article/view/2580

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