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

AJBM crossMark


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


Copyright © 2018 by The American Society for BioMedicine and BM-Publisher, Inc.

Article citationReferencesFull-Text/PDFFeedback
The citation data is computed by the following citation measuring services:

Cited by (CrossRef)
Google Scholar

  1. Blay JY, Bonvalot S, Casali P, Choi H, et al. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST consensus conference of 20–21 March 2004, under the auspices of ESMO. Ann Oncol 2005;16:566-78. M, El-Zohairy MA, Mostafa A, Al-Kalaawy A, El-Sebae H. Gastrointestinal stromal tumors (GISTs), 10-year experience: patterns of failure and prognostic factors for survival of 127 patients. J Egypt Natl Canc Inst 2012;24:31-9.
  2. øreide K, Sandvik OM, Søreide JA, Giljaca V, Jureckova A, Bulusu VR. Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies. Cancer Epidemiol 2016 Feb;40:39-46.
  3. Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pyloriinfection. Am.J. Gastroenterol 2007;102:1808-25.
  4. Abuzakhm SM, Acre-Lara CE, Zhao W, et al. Unusual metastases of gastrointestinal stromal tumor and genotypic correlates: Case report and review of the literature. J Gastrointest Oncol 2011 Mar;2(1):45-9.
    PMid:22811827 PMCid:PMC3397596
  5. Nishida T, Blay JY, Hirota S, Kitagawa Y, Kang YK. The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines. Gastric Cancer 2016;19(1):3-14.
    PMid:26276366 PMCid:PMC4688306
  6. Sihto H, Sarlomo-Rikala M, Tynninen O, et al. KIT and platelet-derived growth factor receptor alpha tyrosine kinase gene mutations and KIT amplifications in human solid tumors. J Clin Oncol 2005 ;23(1):49-57.
  7. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol 2002; 33(5):459-65.
  8. Ma GL, Murphy JD, Martinez ME, Sicklick JK. Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study. Cancer Epidemiol Biomarkers Prev. 2015; 24(1):298-302.
    PMid:25277795 PMCid:PMC4294949
  9. Perez EA, Livingstone AS, Franceschi D, et al. Current incidence and outcomes of gastrointestinal mesenchymal tumors including gastrointestinal stromal tumors. J Am Coll Surg 2006;202(4):623-9.
  10. Jongmin Choi; chung Hyeon Kim; Su Jin chung; et al. Prospective Evaluation of a New Stool Antigen Test for the detection of H. Pylori, in Comparison with Histology, rapid Urease Test, Urea Breathing Test, and serology. J Gastroenterol Hepatol 2011;26(6):1053-1059.
  11. Rubin JL, Sanon M, Taylor DC, Coombs J, Bollu V, Sirulnik L. Epidemiology, survival, and costs of localized gastrointestinal stromal tumors. Int J Gen Med 2011;4:121-30.
    PMid:21475624 PMCid:PMC3068873
  12. Chiang NJ, Chen LT, Tsai CR, Chang JS. The epidemiology of gastrointestinal stromal tumors in Taiwan, 1998-2008: a nation-wide cancer registry-based study. BMC Cancer 201418;14:102.
  13. Coe TM, Fero KE, Fanta PT, et al. Population-Based Epidemiology and Mortality of Small Malignant Gastrointestinal Stromal Tumors in the USA. J Gastrointest Surg 2016;20(6):1132-40.
    PMid:27025710 PMCid:PMC4880518
  14. Salari M, Ahadi M, Hoseini SM, et al. Gastrointestinal Stromal Tumors in Northeastern Iran: 46 Cases During 2003-2012. Middle East J Dig Dis 2015;7:161-5.
    PMid:26396718 PMCid:PMC4560630
  15. Kim MC, Yook JH, Yang HK, et al. Long-Term Surgical Outcome of 1057 Gastric GISTs According to 7th UICC/AJCC TNM System: Multicenter Observational Study From Korea and Japan. Medicine (Baltimore) 2015;94(41):e1526.
    PMid:26469894 PMCid:PMC4616782
  16. Li J, Zhang H, Chen Z, Su K. Clinico-pathological characteristics and prognostic factors of gastrointestinal stromal tumors among a Chinese population. Int J Clin Exp Pathol. 2015;8(12):15969-76.
    PMid:26884871 PMCid:PMC4730084
  17. Patnaik S, Jyotsnarani Y, Rammurti S. Radiological features of metastatic gastrointestinal stromal tumors. J Clin Imaging Sci 2012;2:43.
    PMid:22919557 PMCid:PMC3424815
  18. Yacob M, Inian S, Sudhakar CB. Gastrointestinal Stromal Tumours: Review of 150 Cases from a Single Centre. Indian J Surg 2015;77(Suppl 2):505-10.
    PMid:26730054 PMCid:PMC4692851
  19. Alecu L, Tulin A, Enciu O, Bărbulescu M, Ursuţ B, Obrocea F. Gastrointestinal Stromal Tumors - Diagnosis and Surgical Treatment. Chirurgia (Bucur) 2015;110(6):525-9.
  20. Kramer K, Knippschild U, Mayer B, et al. Impact of age and gender on tumor related prognosis in gastrointestinal stromal tumors (GIST). BMC Cancer 2015;14;15:57.
  21. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol 2008;39(10):1411-9.
  22. Selcukbiricik F, Yalçın S, Tural D, et al. Gastrointestinal stromal tumors in Turkey: experiences from 3 centers. Onkologie 2013;36(1-2):18-24.
  23. Niedźwiecki S, Piekarski J, Jeziorski A. The clinical and histopathological factors in patients operated on for gastric GIST tumors with unclear diagnosis. Adv Clin Exp Med. 2014;23(4):567-73.


For any technique error please contact us and will be response to sending purchase article by email.

Who Can Become a Reviewer?
Any expert in the article's research field can become a reviewer with American Journal of BioMedicine. Editors might ask you to look at a specific aspect of an article.

Find out more

Thank you for visiting American Journal of BioMedicine. * = Required fields

Error: Contact form not found.

Research Article
American Journal of BioMedicine Volume 6, Issue 7, pages 432-440
Received May 21, 2018; accepted June 27, 2018; published July 21, 2018

How to cite this article
Abood RA, Alasady O, Khalaf AA. EGastrointestinal stromal tumors in southern Iraq: clinico-pathologic patterns and risk stratification. American Journal of BioMedicine 2018;6(7):432-440.

Case report outline
1. Abstract
2. Keywords
3. Introduction
4. Methods
5. Results
6. Discussion
7. References

Explore PlumX Metrics