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Web End = Ann Surg Oncol (2015) 22:26332639 DOI 10.1245/s10434-014-4332-z
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Web End = ORIGINAL ARTICLE BONE AND SOFT TISSUE SARCOMAS
Additional Primary Malignancies in Patients with Gastrointestinal Stromal Tumor (GIST): A Clinicopathologic Study of 260 Patients with Molecular Analysis and Review of the Literature
Jaclyn Frances Hechtman, MD1, Ronald DeMatteo, MD2, Khedoudja Nafa, PhD1, Ping Chi, MD, PhD3,Maria E. Arcila, MD1, Snjezana Dogan, MD1, Alifya Oultache, MD1, Wen Chen, MD4, and Meera Hameed, MD1
1Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY; 2Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; 3Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; 4Department of Pathology, Veterans Affairs Hospital, Washington, DC
ABSTRACTBackground. The incidence of other primary neoplasms in gastrointestinal stromal tumor (GIST) patients is relatively high. Our aim was to better characterize the clinicopathologic and molecular relationships in a cohort of GIST patients.
Methods. All GIST patients with tumor samples sent for molecular testing were identied via electronic medical records. Clinicopathologic characteristics of GIST and additional primary malignancies were analyzed.
Results. Of 260 patients, 50 (19 %) had at least one additional primary malignancy. In 33 patients, separate primary neoplasms predated their GIST diagnosis and most commonly included: prostate (n = 9), breast (n = 8), and hematologic (n = 5). Renal (n = 4) and hematologic (n = 3) malignancies were the most frequent cancers identied after GIST diagnosis. The majority (8 of 12, 66 %) of malignancies diagnosed after GIST were found incidentally. Patients who developed other malignancies after GIST more often had KIT exon 11 mutations (100 vs. 66 %, P = 0.01). In comparison to patients with only GIST, patients with a second primary neoplasm of any
chronology had GISTs with increased mitotic rate (C5 per 50 high-power elds) (P = 0.0006). Literature review revealed colorectal cancer, gastric, prostate, renal, leukemia, and desmoid-type bromatosis as the most common secondary neoplasms.
Conclusions. Nineteen percent of GIST patients develop other malignancies. This is the rst report to describe a relationship between additional primary malignancy...