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原发性胰腺 GIST——单中心病例系列及文献系统回顾。

Primary Pancreatic GIST - A-Single Centre Case Series and Systematic Review of Literature.

机构信息

Gastrointestinal and Hepato-pancreato-biliary services, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.

Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.

出版信息

J Gastrointest Cancer. 2024 Jun;55(2):572-583. doi: 10.1007/s12029-024-01024-8. Epub 2024 Feb 7.

Abstract

PURPOSE

GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon, omentum, retroperitoneum, abdominal wall, liver and pancreas with pancreas comprising less than 5% of it. Due to limited data, it is unknown if the results of GIST can be generalised for EGISTs. We thereby present the largest single-centre case series of primary pancreatic GIST so far with review of existing literature.

METHODS

A total of 9 patients of primary pancreatic GIST were treated at our institute from September 2016 to February 2023. After literature search for all studies published before February 2023, 51 articles including 57 patients were identified. Their clinicopathological data and survival analysis were assessed.

RESULTS

The median age of patients treated at our centre was 53 years with a female predominance. The most common epicentre was pancreatic head with abdominal pain as the most common presenting symptom. All 57 patients documented in literature belonged to a similar age group with similar gender predilection. The factors impacting DFS were histologic type, mitotic index, NIH risk category and adjuvant therapy. The median DFS was 74 months with a 5-year DFS being 71.9%, while the 5-year OS was 90.4%.

CONCLUSION

Pancreatic GIST is a rare entity. Due to limited evidence and evolving literature, results cannot be generalised to a larger population. Larger case series with longer follow-up data are required to further understand the disease biology and long-term outcomes of pancreatic GIST.

摘要

目的

起源于胃肠道外器官的 GIST 被定义为胃肠道外 GIST(EGIST)。大多数 EGIST 起源于小肠系膜、结肠系膜、大网膜、腹膜后、腹壁、肝脏和胰腺,其中胰腺不到 5%。由于数据有限,尚不清楚 GIST 的结果是否可以推广到 EGIST。因此,我们目前报告了迄今为止最大的单一中心原发性胰腺 GIST 病例系列,并对现有文献进行了回顾。

方法

本研究共纳入 2016 年 9 月至 2023 年 2 月在我院治疗的 9 例原发性胰腺 GIST 患者。通过对截至 2023 年 2 月发表的所有研究进行文献检索,共确定了 51 篇文章,包括 57 例患者。评估了他们的临床病理数据和生存分析。

结果

在我院治疗的患者的中位年龄为 53 岁,女性居多。最常见的肿瘤部位是胰头部,以腹痛为最常见的首发症状。文献中记录的 57 例患者均属于相似的年龄组,且具有相似的性别倾向。影响 DFS 的因素包括组织学类型、有丝分裂指数、NIH 风险分类和辅助治疗。中位 DFS 为 74 个月,5 年 DFS 为 71.9%,5 年 OS 为 90.4%。

结论

胰腺 GIST 较为少见。由于证据有限且文献不断发展,结果不能推广到更大的人群。需要更大的病例系列和更长的随访数据来进一步了解胰腺 GIST 的疾病生物学和长期结局。

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