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01-09-2015 | Original Article

Underreporting of Gastrointestinal Stromal Tumors: Is the True Incidence Being Captured?

Authors: Audrey H. Choi, John B. Hamner, Shaila J. Merchant, Vijay Trisal, Warren Chow, Carlos A. Garberoglio, Joseph Kim

Published in: Journal of Gastrointestinal Surgery | Issue 9/2015

Abstract

Background

Hospital cancer registries are only required to report gastrointestinal stromal tumors (GISTs) if labeled malignant or metastatic, leading to potential loss of cases in national cancer registries. Our objective was to determine whether GISTs are underreported in the US.

Methods

Retrospective review of pathology reports between 2010 and 2013 with diagnosis of GIST was performed at two academic medical centers. Recurrent GISTs were excluded. Pathology reports were cross-referenced to cases reported by each cancer registry. Risk for metastasis/death was determined according to National Comprehensive Cancer Network (NCCN) guidelines.

Results

Forty-nine cases of non-recurrent GIST were identified. Only 19/49 (38.8 %) cases were reported. None of the 30 non-reported cases were labeled malignant/metastatic on final pathology. To illustrate malignant potential, these tumors were risk stratified. Most (60 %) of the non-reported cases were low risk, but there were 4 (13.3 %) cases each in the intermediate, high, and unknown risk groups. Additionally, 7/30 (23.0 %) cases were treated with tyrosine kinase inhibitors, highlighting clinical concern of malignant GIST.

Conclusions

Our results show that nearly two thirds of GIST cases have been underreported, suggesting that current reporting practices underestimate its true incidence. Revision of reporting guidelines may result in a more accurate estimation of the US disease burden of GIST.

Pisters, P.W., C.D. Blanke, M. von Mehren, J. Picus, A. Sirulnik, E. Stealey, J.C. Trent, and G.S.C. re, A USA registry of gastrointestinal stromal tumor patients: changes in practice over time and differences between community and academic practices. Ann Oncol, 2011. 22(11): p. 2523–9.

Rubin, J.L., M. Sanon, D.C. Taylor, J. Coombs, V. Bollu, and L. Sirulnik, Epidemiology, survival, and costs of localized gastrointestinal stromal tumors. Int J Gen Med, 2011. 4: p. 121–30.PubMedCentralPubMed

Fletcher, C.D., J.J. Berman, C. Corless, F. Gorstein, J. Lasota, B.J. Longley, M. Miettinen, T.J. O’Leary, H. Remotti, B.P. Rubin, B. Shmookler, L.H. Sobin, and S.W. Weiss, Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol, 2002. 33(5): p. 459–65.CrossRefPubMed

College of American Pathologists Protocol for the Examination of Specimens From Patients With Gastrointestinal Stromal Tumor (GIST). 2014 March 10, 2015; Available from: http://www.cap.org/ShowProperty?nodePath=/UCMCon/Contribution%20Folders/WebContent/pdf/cp-gist-14protocol.pdf.

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): p. 461–71.PubMedCentralPubMed

Miettinen, M., H. Makhlouf, L.H. Sobin, and J. Lasota, Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol, 2006. 30(4): p. 477–89.CrossRefPubMed

Miettinen, M., L.H. Sobin, and J. Lasota, Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol, 2005. 29(1): p. 52–68.CrossRefPubMed

Joensuu, H., A. Vehtari, J. Riihimaki, T. Nishida, S.E. Steigen, P. Brabec, L. Plank, B. Nilsson, C. Cirilli, C. Braconi, A. Bordoni, M.K. Magnusson, Z. Linke, J. Sufliarsky, M. Federico, J.G. Jonasson, A.P. Dei Tos, and P. Rutkowski, Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts. Lancet Oncol, 2012. 13(3): p. 265–74.CrossRefPubMed

California Department of Public Health: California Cancer Registry Overview. 2014 [cited 2014 November 4]; Available from: http://www.ccrcal.org/Inside_CCR/FAQ.shtml#ccr do1.

10.

Nilsson, B., P. Bumming, J.M. Meis-Kindblom, A. Oden, A. Dortok, B. Gustavsson, K. Sablinska, and L.G. Kindblom, Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era--a population-based study in western Sweden. Cancer, 2005. 103(4): p. 821–9.

11.

Hirota, S., K. Isozaki, Y. Moriyama, K. Hashimoto, T. Nishida, S. Ishiguro, K. Kawano, M. Hanada, A. Kurata, M. Takeda, G. Muhammad Tunio, Y. Matsuzawa, Y. Kanakura, Y. Shinomura, and Y. Kitamura, Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science, 1998. 279(5350): p. 577–80.CrossRefPubMed

12.

Surveillance, Epidemiology, and End Results Program: SEER Inquiry System (Question 20100014). 2014 [cited 2014 October 29]; Available from: seer.cancer.gov/seerinquiry/index.php?page = view&id = 20100014&type = q.

13.

Surveillance, Epidemiology, and End Results Program: SEER Inquiry System (Question 20091021). 2014 [cited 2014 October 29]; Available from: seer.cancer.gov/seerinquiry/index.php?page = view&id = 20091021&type = q.

14.

Demetri, G.D., M. von Mehren, C.R. Antonescu, R.P. DeMatteo, K.N. Ganjoo, R.G. Maki, P.W. Pisters, C.P. Raut, R.F. Riedel, S. Schuetze, H.M. Sundar, J.C. Trent, and J.D. Wayne, NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw, 2010. 8 Suppl 2: p. S1-41; quiz S42-4

15.

Surveillance, Epidemiology, and End Results Program: SEER Inquiry System (Question 20021151). 2014 [cited 2014 October 29]; Available from: seer.cancer.gov/seerinquiry/index.php?page = viewid = 20021151&type = q.

Title: Underreporting of Gastrointestinal Stromal Tumors: Is the True Incidence Being Captured?
Authors: Audrey H. Choi
John B. Hamner
Shaila J. Merchant
Vijay Trisal
Warren Chow
Carlos A. Garberoglio
Joseph Kim
Publication date: 01-09-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 9/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2860-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Underreporting of Gastrointestinal Stromal Tumors: Is the True Incidence Being Captured?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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