Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Clinical Research Center for Breast Diseases, Laboratory of Molecular Diagnosis of Cancer, and Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
World J Surg Oncol. 2020 May 6;18(1):88. doi: 10.1186/s12957-020-01868-x.
To explore overall survival (OS) and GISTs-specific survival (GSS) among cancer survivors developing a second primary gastrointestinal stromal tumors (GISTs).
We conducted a cohort study, where patients with GISTs after another malignancy (AM-GISTs, n = 851) and those with only GISTs (GISTs-1, n = 7660) were identified from the Surveillance, Epidemiology, and End Results registries (1988-2016). Clinicopathologic characteristics and survival were compared between the two groups.
The most commonly diagnosed first primary malignancy was prostate cancer (27.7%), followed by breast cancer (16.2%). OS among AM-GISTs was significantly inferior to that of GISTs-1; 10-year OS was 40.3% vs. 50.0%, (p < 0.001). A contrary finding was observed for GSS (10-year GSS 68.9% vs. 61.8%, p = 0.002). In the AM-GISTs group, a total of 338 patients died, of which 26.0% died of their initial cancer and 40.8% died of GISTs. Independent of demographics and clinicopathological characteristics, mortality from GISTs among AM-GISTs patients was decreased compared with their GISTs-1 counterparts (HR, 0.71; 95% CI, 0.59-0.84; p < 0.001), whereas OS was inferior among AM-GISTs (HR, 1.11; 95% CI, 0.99-1.25; p = 0.085).
AM-GISTs patients have decreased risk of dying from GISTs compared with GIST-1. Although another malignancy history does not seemingly affect OS for GISTs patients, clinical treatment of such patients should be cautious.
探索癌症幸存者中发生第二原发胃肠道间质瘤（GISTs）的总生存（OS）和 GISTs 特异性生存（GSS）。
我们进行了一项队列研究，从监测、流行病学和最终结果登记处（1988-2016 年）中确定了患有另一种恶性肿瘤（AM-GISTs，n=851）后的 GISTs 患者和仅患有 GISTs（GISTs-1，n=7660）的患者。比较两组的临床病理特征和生存情况。
最常见的首发恶性肿瘤是前列腺癌（27.7%），其次是乳腺癌（16.2%）。AM-GISTs 的 OS 明显低于 GISTs-1；10 年 OS 为 40.3% vs. 50.0%，（p<0.001）。而 GSS 则出现相反的结果（10 年 GSS 为 68.9% vs. 61.8%，p=0.002）。在 AM-GISTs 组中，共有 338 例患者死亡，其中 26.0%死于初始癌症，40.8%死于 GISTs。无论人口统计学和临床病理特征如何，与 GISTs-1 相比，AM-GISTs 患者死于 GISTs 的死亡率均降低（HR，0.71；95%CI，0.59-0.84；p<0.001），而 OS 则较差（HR，1.11；95%CI，0.99-1.25；p=0.085）。
与 GISTs-1 相比，AM-GISTs 患者死于 GISTs 的风险降低。尽管有另一种恶性肿瘤病史似乎不会影响 GISTs 患者的 OS，但对这类患者的临床治疗应谨慎。
