Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira de Cancerologia (Online) |
Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/635 |
Resumo: | Introduction: Gastrointestinal stromal tumors (GIST ) are rare neoplasms that originate from interstitial cells of Cajal. Objectives: To describe the experience at the Curitiba Clinical Hospital in the treatment of both localized and advanced GIST, with analysis of clinical and anatomical and pathological characteristics and use of imatinib. Methodology: A retrospective study of 32 patients diagnosed for immunohistochemistry, c-Kit positive, from 2003 to 2008. Results: The median age was 66 years, the median tumor size was 8.4 cm and the most common sites were the tomach in 46.9% and the small intestine in 40.9%. Patients at high risk of progressive disease: 37.5%. 23 patients had localized disease at diagnosis, 39.1% relapsed, and 9 patients had advanced disease. The median follow up was 43.7 months, overall survival at 5 years for the total group of 56.2%. In localized disease, overall survival at 5 years was 73.8% and 37.5% in advanced disease (p=0.03). There was no impact of prognostic factors on survival. The use of imatinib occurred in 16 patients, 43.8% due to initial metastasis, 37.5% disease progression, 12.5% local recurrence and 6.2% compromised margins. The median overall survival with the use of imatinib was 53 months and the first progression-free survival of 32.9 months. There was good tolerance to imatinib and only two patients received sunitinib. Conclusion: Predominant tumors were large, gastric-sited and of high risk of progression. The relapse rate was high in localized disease. And overall survival of patients with localized disease and who used the imatinib was considered satisfactory. |
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Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal UniversityTumor del Estroma Gastrointestinal: Experiencia en el Tratamiento de la Enfermedad Localizada y Avanzada en el Hospital de Clínicas de la Universidad Federal de ParanáTumor Estromal Gastrointestinal: Experiência no Tratamento da Doença Localizada e Avançada no Hospital de Clínicas da Universidade Federal do ParanáTumores do Estroma GastrointestinalAntineoplásicos/uso terapêuticoMesilatosProteínas Proto- Oncogênicas c-kitImunoistoquímicaEstudos RetrospectivosGastrointestinal Stromal TumorsAntineoplastic Agents/therapeutic useMesylatesProto-Oncogene Proteins c-kitImmunohistochemistryRetrospective StudiesTumores del Estroma GastrointestinalAgentes Antineoplásicos/uso terapéutico;MesilatosProteínas Proto-Oncogénicas c-kitInmunohistoquímicaEstudios RetrospectivosIntroduction: Gastrointestinal stromal tumors (GIST ) are rare neoplasms that originate from interstitial cells of Cajal. Objectives: To describe the experience at the Curitiba Clinical Hospital in the treatment of both localized and advanced GIST, with analysis of clinical and anatomical and pathological characteristics and use of imatinib. Methodology: A retrospective study of 32 patients diagnosed for immunohistochemistry, c-Kit positive, from 2003 to 2008. Results: The median age was 66 years, the median tumor size was 8.4 cm and the most common sites were the tomach in 46.9% and the small intestine in 40.9%. Patients at high risk of progressive disease: 37.5%. 23 patients had localized disease at diagnosis, 39.1% relapsed, and 9 patients had advanced disease. The median follow up was 43.7 months, overall survival at 5 years for the total group of 56.2%. In localized disease, overall survival at 5 years was 73.8% and 37.5% in advanced disease (p=0.03). There was no impact of prognostic factors on survival. The use of imatinib occurred in 16 patients, 43.8% due to initial metastasis, 37.5% disease progression, 12.5% local recurrence and 6.2% compromised margins. The median overall survival with the use of imatinib was 53 months and the first progression-free survival of 32.9 months. There was good tolerance to imatinib and only two patients received sunitinib. Conclusion: Predominant tumors were large, gastric-sited and of high risk of progression. The relapse rate was high in localized disease. And overall survival of patients with localized disease and who used the imatinib was considered satisfactory. Introducción: Los tumores del estroma gastrointestinales (GIST) son neoplasias raras que se originan en las células intersticiales de Cajal. Objetivo: Describir la experiencia del Hospital de Clínicas de Curitiba en el tratamiento de tumores de GIST localizado y avanzado, con análisis de las características clínicas, anatómicas y patológicas, además del uso de imatinib. Método: Estudio retrospectivo de 32 pacientes con diagnóstico por inmune histoquímica, c-Kit positivo, en el período de 2003 a 2008. Resultados: Franja etaria de 66 años, el tamaño mediano del tumor 8,4 cm y los locales más frecuentes fueron el estómago en 46,9% e intestino delgado en 40,9%. Pacientes con alto riesgo de agresividad: el 37,5% presentaban enfermedad localizada en el diagnóstico de 23 pacientes: 39,1% recayeron y 9 de enfermedad avanzada. El resultado mediano fue de 43,7 meses, con supervivencia global en 5 años en el grupo total de 56,2%. En cuanto a la enfermedad localizada, la supervivencia en 5 años fue de 73,8% y en la avanzada de 37,5% (p=0,03). No hubo un impacto de los factores pronósticos en la supervivencia. El mesilato de imatinib fue usado en 16 pacientes: el 43,8% por metástasis inicial, el 37,5% recaída a distancia, el 12,5% recaída local y el 6,2% margen afectada. La supervivencia global con el uso del imatinib mediana fue de 53 meses y la supervivencia libre de primera progresión de 32,9 meses. Hubo buena tolerabilidad al imatinib y solo dos pacientes utilizaron el sunitinib. Conclusión: La mayoría de los tumores era grande, de localización gástrica y de alto riesgo de agresión. La tasa de recaída es alta en la enfermedad localizada. Y la supervivencia global de pacientes con enfermedad localizada y que utilizaron el imatinib se considera satisfactoria.Introdução: Tumores estromais gastrointestinais (GIST) são neoplasias raras que se originam das células intersticiais de Cajal. Objetivo: Descrever a experiência do Hospital de Clínicas de Curitiba no tratamento do GIST localizado e avançado, com análise das características clínicas e anatomopatológicas e uso do imatinibe. Método: Estudo retrospectivo com 32 pacientes com diagnóstico por imuno-histoquímica, c-Kit positivo, no período de 2003 a 2008. Resultados: Idade mediana: 66 anos; tamanho mediano do tumor de 8,4 cm; e as localizações mais frequentes foram estômago em 46,9% e intestino delgado em 40,9%. Pacientes com alto risco de agressividade: 37,5%; apresentavam doença localizada no diagnóstico 23 pacientes: 39,1% recaíram e 9 com doença avançada. O seguimento mediano foi de 43,7 meses, com sobrevida global em 5 anos no grupo total de 56,2%. Na doença localizada, a sobrevida global em 5 anos foi de 73,8% e na avançada de 37,5% (p=0,03). Não ocorreu impacto dos fatores prognósticos na sobrevida. Utilizou-se o mesilato de imatinibe em 16 pacientes: 43,8% por metástase inicial, 37,5% recaída a distância, 12,5% recaída local e 6,2% margem comprometida. A sobrevida global com uso do imatinibe mediana foi de 53 meses e a sobrevida livre de primeira progressão de 32,9 meses. Houve boa tolerabilidade ao imatinibe e apenas dois pacientes utilizaram o sunitinibe. Conclusão: A maioria dos tumores era grande, de localização gástrica e de alto risco de agressividade. A taxa de recaída na doença localizada foi alta. E a sobrevida global dos pacientes de doença localizada e que utilizaram o imatinibe foi considerada satisfatória. INCA2012-03-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionArtigos, Avaliado pelos paresapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/63510.32635/2176-9745.RBC.2012v58n1.635Revista Brasileira de Cancerologia; Vol. 58 No. 1 (2012): Jan./Feb./Mar.; 47-56Revista Brasileira de Cancerologia; Vol. 58 Núm. 1 (2012): ene./feb./mar.; 47-56Revista Brasileira de Cancerologia; v. 58 n. 1 (2012): jan./fev./mar. ; 47-562176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporhttps://rbc.inca.gov.br/index.php/revista/article/view/635/419Vianna, Karina Costa Maia Padilha, Sérgio Lunardon Ferronatto, Bianca RamosUratani, Lucas FernandoAlmeida, Felipe Augusto Santiago de Zanis Neto, José info:eu-repo/semantics/openAccess2021-11-29T20:15:09Zoai:rbc.inca.gov.br:article/635Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2021-11-29T20:15:09Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
dc.title.none.fl_str_mv |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University Tumor del Estroma Gastrointestinal: Experiencia en el Tratamiento de la Enfermedad Localizada y Avanzada en el Hospital de Clínicas de la Universidad Federal de Paraná Tumor Estromal Gastrointestinal: Experiência no Tratamento da Doença Localizada e Avançada no Hospital de Clínicas da Universidade Federal do Paraná |
title |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University |
spellingShingle |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University Vianna, Karina Costa Maia Tumores do Estroma Gastrointestinal Antineoplásicos/uso terapêutico Mesilatos Proteínas Proto- Oncogênicas c-kit Imunoistoquímica Estudos Retrospectivos Gastrointestinal Stromal Tumors Antineoplastic Agents/therapeutic use Mesylates Proto-Oncogene Proteins c-kit Immunohistochemistry Retrospective Studies Tumores del Estroma Gastrointestinal Agentes Antineoplásicos/uso terapéutico; Mesilatos Proteínas Proto-Oncogénicas c-kit Inmunohistoquímica Estudios Retrospectivos |
title_short |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University |
title_full |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University |
title_fullStr |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University |
title_full_unstemmed |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University |
title_sort |
Gastrointestinal Stromal Tumor: Experience in the Treatment of Localized and Advanced Disease at the Clinical Hospital of Parana Federal University |
author |
Vianna, Karina Costa Maia |
author_facet |
Vianna, Karina Costa Maia Padilha, Sérgio Lunardon Ferronatto, Bianca Ramos Uratani, Lucas Fernando Almeida, Felipe Augusto Santiago de Zanis Neto, José |
author_role |
author |
author2 |
Padilha, Sérgio Lunardon Ferronatto, Bianca Ramos Uratani, Lucas Fernando Almeida, Felipe Augusto Santiago de Zanis Neto, José |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Vianna, Karina Costa Maia Padilha, Sérgio Lunardon Ferronatto, Bianca Ramos Uratani, Lucas Fernando Almeida, Felipe Augusto Santiago de Zanis Neto, José |
dc.subject.por.fl_str_mv |
Tumores do Estroma Gastrointestinal Antineoplásicos/uso terapêutico Mesilatos Proteínas Proto- Oncogênicas c-kit Imunoistoquímica Estudos Retrospectivos Gastrointestinal Stromal Tumors Antineoplastic Agents/therapeutic use Mesylates Proto-Oncogene Proteins c-kit Immunohistochemistry Retrospective Studies Tumores del Estroma Gastrointestinal Agentes Antineoplásicos/uso terapéutico; Mesilatos Proteínas Proto-Oncogénicas c-kit Inmunohistoquímica Estudios Retrospectivos |
topic |
Tumores do Estroma Gastrointestinal Antineoplásicos/uso terapêutico Mesilatos Proteínas Proto- Oncogênicas c-kit Imunoistoquímica Estudos Retrospectivos Gastrointestinal Stromal Tumors Antineoplastic Agents/therapeutic use Mesylates Proto-Oncogene Proteins c-kit Immunohistochemistry Retrospective Studies Tumores del Estroma Gastrointestinal Agentes Antineoplásicos/uso terapéutico; Mesilatos Proteínas Proto-Oncogénicas c-kit Inmunohistoquímica Estudios Retrospectivos |
description |
Introduction: Gastrointestinal stromal tumors (GIST ) are rare neoplasms that originate from interstitial cells of Cajal. Objectives: To describe the experience at the Curitiba Clinical Hospital in the treatment of both localized and advanced GIST, with analysis of clinical and anatomical and pathological characteristics and use of imatinib. Methodology: A retrospective study of 32 patients diagnosed for immunohistochemistry, c-Kit positive, from 2003 to 2008. Results: The median age was 66 years, the median tumor size was 8.4 cm and the most common sites were the tomach in 46.9% and the small intestine in 40.9%. Patients at high risk of progressive disease: 37.5%. 23 patients had localized disease at diagnosis, 39.1% relapsed, and 9 patients had advanced disease. The median follow up was 43.7 months, overall survival at 5 years for the total group of 56.2%. In localized disease, overall survival at 5 years was 73.8% and 37.5% in advanced disease (p=0.03). There was no impact of prognostic factors on survival. The use of imatinib occurred in 16 patients, 43.8% due to initial metastasis, 37.5% disease progression, 12.5% local recurrence and 6.2% compromised margins. The median overall survival with the use of imatinib was 53 months and the first progression-free survival of 32.9 months. There was good tolerance to imatinib and only two patients received sunitinib. Conclusion: Predominant tumors were large, gastric-sited and of high risk of progression. The relapse rate was high in localized disease. And overall survival of patients with localized disease and who used the imatinib was considered satisfactory. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-03-30 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Artigos, Avaliado pelos pares |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/635 10.32635/2176-9745.RBC.2012v58n1.635 |
url |
https://rbc.inca.gov.br/index.php/revista/article/view/635 |
identifier_str_mv |
10.32635/2176-9745.RBC.2012v58n1.635 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/635/419 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
INCA |
publisher.none.fl_str_mv |
INCA |
dc.source.none.fl_str_mv |
Revista Brasileira de Cancerologia; Vol. 58 No. 1 (2012): Jan./Feb./Mar.; 47-56 Revista Brasileira de Cancerologia; Vol. 58 Núm. 1 (2012): ene./feb./mar.; 47-56 Revista Brasileira de Cancerologia; v. 58 n. 1 (2012): jan./fev./mar. ; 47-56 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
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Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
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INCA |
institution |
INCA |
reponame_str |
Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
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rbc@inca.gov.br |
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1797042245201821696 |