Gastrointestinal stromal tumors in southern Iraq: clinico-pathologic patterns and risk stratification

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Rafid A Abood ¹, Osama Gh. Alasady ², Asaad A Khalaf ^²*

∗Correspondence author e-mail: rafidalkhalidy79@hotmail.com: ¹Basra Oncology Center, Basra College of Medicine, Basra, Iraq. Basra Oncology Center, Iraq

Abstract

There was no local or nation-wide data on the patterns of Gastrointestinal Stromal Tumors (GISTs) in Iraq. This study was undertaken to determine the clinical and pathologic characteristics and risk stratification of GISTs in Iraqi patients over a nine years’ period. This is a retrospective descriptive study. Medical notes and histopathological reports of patients with confirmed diagnosis of GIST between January 2007 and August 2015 were reviewed for age, gender, tumor location, CD117 status, tumor stage, and National Institutes of Health (NIH) risk classification. Forty-seven patients were included in the study. Mean age at time of diagnosis was 57 years (range 29 to 85 years), and male to female ratio was 1:1. Most common sites of involvement of GISTs were stomach (21/47), and jejunum/ ileum (16/47). Immunohistochemistry for CD117 was positive in 33 cases. Out of the 47 cases, 4 were locally advanced and 15 were metastasized. The most common site for metastasis was liver (53%) followed by pulmonary (40%) and retroperitoneum (7%). Risk stratification was done for only 41 cases; 61% were stratified as high risks group, 12% belonged to intermediate risk category, while the rest 27% were stratified as very low and low risk groups. While the epidemiological patterns of GIST from Iraq resembles those from elsewhere, the disease was more advanced in Iraqi patients when compared to Western countries. At the time of diagnosis, majority of our cases were stratified under high-risk category.

Keywords: Gastrointestinal Stromal Tumors, CD117, Risk stratification, Epidemiology, Clinico-pathological features

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