Gastrointestinal stromal tümörler: Tek merkez deneyimi-demografik ve patolojik bulguların analizi

Öz

Amaç: Gastrointestinal stromal tümörler (GİST), gastrointestinal sistemin en sık görülen mezenkimal neoplazmları olup sıklıkla mide ve ince bağırsaktan kaynaklanmaktadır. Nadir görülmelerine rağmen, son yıllarda moleküler biyoloji ve hedefe yönelik tedavi alanındaki gelişmeler klinik sonuçları anlamlı düzeyde iyileştirmiştir. Bu tek merkezli retrospektif çalışmanın amacı, GİST tanısı almış hastaların demografik, patolojik ve tedaviye ilişkin özelliklerini değerlendirmek; rekürrenssiz sağkalım (RFS) süresini ve tedaviye bağlı tolerabiliteyi gerçek yaşam koşullarında incelemektir. Gereç ve Yöntemler: Eylül 2022 ile Eylül 2024 tarihleri arasında Ankara Etlik Şehir Hastanesi'nde GİST tanısı almış hastaların tıbbi kayıtları retrospektif olarak incelenmiştir. Demografik özellikler, tümör lokalizasyonu, mitotik indeks, immünohistokimyasal belirteçler, KIT/PDGFRA mutasyon durumu, cerrahi ve sistemik tedavi verileri, advers olaylar ve sağkalım sonuçları analiz edilmiştir. RFS, tedavi başlangıcından itibaren nüks, ölüm veya son takip tarihine kadar geçen süre olarak tanımlanmıştır. Bulgular: Toplam 46 hasta çalışmaya dahil edilmiş olup, ortanca yaş 62,9 yıl (aralık: 41,8–82,0) ve %58,7’si erkekti. Tümörlerin en sık yerleşim yerleri mide (%60,9) ve ince bağırsak (%34,8) idi. Tüm hastalara cerrahi rezeksiyon uygulanmış, %84,8’inde R0 rezeksiyon sağlanmıştır. Hastaların %58,7’sine adjuvan imatinib tedavisi verilmiş, bu grubun %19,6’sında advers etki bildirilmiştir. Ortanca 16,8 aylık takip süresi boyunca 4 hastada (%8,7) nüks saptanmış, 1 hasta (%2,2) yaşamını yitirmiştir. Ortanca RFS’ye ulaşılamamıştır. Tümör boyutu, rezeksiyon durumu ve diğer klinik değişkenler ile RFS arasında tek değişkenli analizde istatistiksel olarak anlamlı ilişki saptanmamıştır. Sonuç: Bu çalışma, GİST hastalarının gerçek yaşam verilerine dayalı klinik ve patolojik özelliklerine ışık tutmaktadır. Bulgular literatürle büyük ölçüde uyumlu olsa da, hasta sayısının sınırlı oluşu ve kısa takip süresi nedeniyle uzun dönem prognostik faktörlerin daha net belirlenebilmesi için prospektif ve çok merkezli çalışmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler

• GİST
• İmatinib
• progresyon
• yan etki

Gastrointestinal stromal tumors analysis of demographic and pathological findings: Single center experience

Öz

Aim: Gastrointestinal stromal tumors (GISTs) represent the most common mesenchymal neoplasms of the gastrointestinal tract, frequently arising from the stomach and small intestine. Despite their rarity, recent advances in molecular biology and targeted therapies have significantly improved clinical outcomes. This single-center retrospective study aimed to characterize the demographic, pathological, and treatment-related features of patients diagnosed with GIST, and to evaluate recurrence-free survival (RFS) and treatment tolerability under real-world clinical conditions. Material and Methods: We retrospectively reviewed medical records of patients diagnosed with GIST at Ankara Etlik City Hospital between September 2022 and September 2024. Data regarding demographic characteristics, tumor localization, mitotic index, immunohistochemical profile, KIT/PDGFRA mutation status, surgical outcomes, targeted therapy administration, adverse events, and survival metrics were analyzed. RFS was defined as the time from treatment initiation to recurrence, death, or last follow-up. Results: A total of 46 patients were included, with a median age of 62.9 years (range: 41.8–82.0); 58.7% were male. The most common tumor sites were the stomach (60.9%) and small intestine (34.8%). All patients underwent surgical resection, with R0 resection achieved in 84.8%. Adjuvant imatinib therapy was administered to 58.7% of patients, and adverse effects were reported in 19.6% of those treated. During a median follow-up of 16.8 months, recurrence occurred in 4 patients (8.7%) and 1 patient (2.2%) died. Median RFS was not reached. Tumor size, resection margin status, and other clinical variables showed no statistically significant association with RFS in univariate analysis. Conclusions: This study provides insight into the clinical and pathological characteristics of GIST patients in a real-world setting. While the findings are largely consistent with existing literature, the limited sample size and short follow-up period underscore the need for prospective, multicenter studies to better define long-term prognostic factors and optimize treatment strategies.

Anahtar Kelimeler

• GIST
• Imatinib
• progression
• side effects

Kaynakça

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