Department of Visceral Surgery, National University Hospital Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Republic of Benin.
Department of Hepato-Gastroenterology, National University Hospital Hubert Koutoukou Maga (CNHU-HKM), Cotonou, Republic of Benin.
World J Surg Oncol. 2022 Dec 1;20(1):247. doi: 10.1186/s12957-022-02709-9.
GISTs are rare tumors but the most frequent mesenchymal tumors of the digestive tract. Diagnosis and treatment are challenging in low-income countries due to relatively poor access to immunohistochemistry and targeted therapy. In Africa, there are few studies about it. Imatinib, an oral targeted therapy, has been available in Benin since 2010 and free since 2016. This study describes the diagnosis and therapeutic management of GIST in Cotonou, Benin.
This is a descriptive cross-sectional study, with retrospective data collection over a 10-year period from 2010 to 2020, focused on patients with histological confirmed gastro-intestinal stromal tumor (GIST). Cases were identified using the registry database and the archival files of the Hubert Koutoukou Maga National University Hospital of Cotonou (CNHU-HKM).
Fifteen GISTs were identified during the study period. The median age was 52 and the sex ratio was 2:1 (10 males and 5 females). The most frequent symptom was abdominal pain (n = 12). Delay in care seeking after onset of symptoms ranged from 24 h to 15 years. The most common site for GISTs was the stomach (n = 8). The median tumor size was 11 cm and the majority (n=10) was metastatic or locally advanced at the time of diagnosis. The tumors were often spindle-shaped at histology (n = 13) and the majority expressed KIT (n = 14). Most of the tumors (n = 12) were at high risk of recurrence according to the Joensuu scoring system. The availability of imatinib has improved the outcome of GIST with response in all cases it was used in neoadjuvant setting (n = 7).
GISTs are rare tumors and preferentially affect the stomach in Cotonou). Most of the tumors were large, unresectable at the time of diagnosis and at high risk of recurrence. Access to imatinib has revolutionized the management of those tumors in our country.
GIST 是一种罕见的肿瘤，但却是消化道最常见的间叶性肿瘤。由于免疫组织化学和靶向治疗的可及性相对较差，在低收入国家，其诊断和治疗具有挑战性。在非洲，关于 GIST 的研究很少。伊马替尼是一种口服靶向治疗药物，自 2010 年以来在贝宁供应，2016 年以来免费供应。本研究描述了贝宁科托努的 GIST 的诊断和治疗管理。
这是一项描述性的横断面研究，回顾性收集了 2010 年至 2020 年 10 年间的资料，重点是组织学证实的胃肠间质瘤（GIST）患者。使用登记数据库和科托努 Hubert Koutoukou Maga 国立大学医院（CNHU-HKM）的档案文件确定病例。
研究期间共发现 15 例 GIST。中位年龄为 52 岁，性别比为 2:1（10 例男性，5 例女性）。最常见的症状是腹痛（n = 12）。症状出现后寻求治疗的时间延迟范围为 24 小时至 15 年。GIST 最常见的部位是胃（n = 8）。肿瘤的中位大小为 11cm，大多数（n=10）在诊断时已经转移或局部晚期。组织学上肿瘤常呈梭形（n = 13），大多数（n = 14）表达 KIT。根据 Joensuu 评分系统，大多数肿瘤（n = 12）为高复发风险。伊马替尼的供应改善了 GIST 的预后，所有使用新辅助方案的病例均有反应（n = 7）。
GIST 是一种罕见的肿瘤，在科托努主要影响胃。大多数肿瘤较大，在诊断时无法切除，且有较高的复发风险。获得伊马替尼使我们国家的这些肿瘤的治疗发生了革命性的变化。
