PTU-142 High Prevalence Of Gastrointestinal Stromal Tumours (gists): A Case Series In Uk Secondary Care

Abstract

INTRODUCTION: Gastrointestinal Stromal Tumours (GISTs) are mesenchymal tumours, predominantly affecting the GI tract. Diagnosis and classification require specialist review and there are few published data on the incidence of GIST in the UK. Reported incidences elsewhere vary between 6.5/ million/ year in Norway and 14.5/ million/year in Sweden1,2. We have analysed our caseload of GISTs in a UK secondary care setting with a population of approx 350,000, in order to estimate incidence and review outcomes. AIMS & METHODS: A retrospective case note reviews of all patients with GIST, as identified from upper GI cancer multidisciplinary team meeting (MDT) minutes, from 2008 to 2013 inclusive (6 years). The diagnosis of GIST was considered valid, if characteristic imaging and/ or pathological features were verified by CT scanning, endoscopic ultrasound (EUS) needle aspiration/ biopsy and/ or surgical resection. RESULTS: We identified 34 cases with a final diagnosis of GIST. The observed incidence of presentation to hospital varied year on year, and estimated annualised incidence was calculated at 16.2 / million/year. The age range was 28-91 years (M 15, F19). Nineteen cases (59%) presented with signs or symptoms of GI blood loss; five (15%) with other GI symptoms and remaining cases were found incidentally. The size of GIST at presentation ranged from 1cm to 20 cm in diameter. One case had metastasised at the time of diagnosis. EUS was used for diagnosis and staging in 15 cases; 13 had fine needle aspiration, of which 10/13 were diagnostic. 26/34((76%) cases underwent resection surgery. 6 cases were treated with Imatinib (Glivec). Case follow up range from 3 months to 6 years. Two patients died, one patient presented with metastatic disease other was managed with palliative approach due to advance age and co-morbidities. CONCLUSION: Our review suggests a higher than expected incidence of GISTs in this population compared with other published series1,2. Most cases present with GI blood loss and surgery is curative in most cases with good prognosis. The incidence of GISTs in the UK is deserving of further study.