Gastrointestinal stromal tumor in North Africa and the middle east: updates in presentation and management from an 11-year retrospective cohort

• Published in: Hospital practice (1995) 2023-12, Vol.51 (5), p.275-287
• Main Authors: Farhat, Fadi, Hussein, Marwa, Sbaity, Eman, Alsharm, Abdullah, Rasul, Kakil, Khairallah, Saad, Assi, Tarek, Allahverdi, Niloofar, Othman, Ahmad, Kattan, Joseph
• Format: Article
• Language: English
• Subjects: Adult; Africa, Northern - epidemiology; Aged; Antineoplastic Agents - adverse effects; Female; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - drug therapy; Gastrointestinal Neoplasms - epidemiology; Gastrointestinal Stromal Tumors - diagnosis; Gastrointestinal Stromal Tumors - drug therapy; Gastrointestinal Stromal Tumors - epidemiology; Humans; Imatinib Mesylate - therapeutic use; Male; Middle Aged; Middle East - epidemiology; Retrospective Studies
• ISSN: 2154-8331; 2377-1003
• DOI: 10.1080/21548331.2023.2277682

This study described the epidemiological, clinical, and survival profiles of patients with gastrointestinal stromal tumor (GIST) in North Africa and the Middle East (AfME). This regional, multicenter, observational, retrospective study collected 11-year data on demographics, medical history, disease characteristics, current treatment approaches of GIST, the safety of the most common tyrosine kinase inhibitors (TKIs), second cancers, and survival status. Data of 201 eligible patients were analyzed: mean age was 56.9 ± 12.6 years; 111 (55.2%) patients were men, 21 (10.4%) patients had previous personal malignancy. The most common clinical presentation of GIST was dysphagia [92 (45.8%) patients]. The stomach was the most common primary site in 120 (60.7%) patients, 171 (85.1%) patients had localized disease at diagnosis. 198 (98.5%) GIST cases were CD117/CD34-positive. Imatinib was used in the neoadjuvant (18/21 patients), adjuvant (85/89 patients), and first-line metastatic treatment (28/33 patients) settings. The most common non-hematological toxicity associated with TKIs was vomiting in 32/85 (37.6%) patients. Overall, 100 (49.8%) patients (95%CI: 42.8-56.7%) were alive and disease-free while 30 (14.9%) patients were alive with active disease. Presentation of GIST in our AfME population is consistent with global reports, being more frequent in patients >50 years old and having the stomach as the most common primary site. Unlike what is usually reported, though, we did have more patients with lymphatic spread of the disease. Despite the global trend and advances in the treatment of GIST according to molecular profile, this is still far to happen in our population given the lack of access to molecular profiles and the high associated cost.