Treatment for Young Adults With GIST May Differ From Older Adults GIST Patients
Young adult patients with GIST are more likely to undergo surgical management.
A new study is suggesting that adolescents and young adult (AYA) patients with gastrointestinal stromal tumors (GIST) are more likely to undergo surgical management than older adult patients. In addition, researchers have found that operative management is associated with improved overall survival (OS) and GIST-specific survival (GSS).
GISTs arise in the wall of the digestive tract and most often occur in the stomach or small intestine. Though more common in later in life, GISTs can occur in AYA patients (aged 13-39). Researchers at the University of California, San Diego School of Medicine report findings from the first population-based analysis of AYA patients with GIST.1
Investigators conducted a retrospective cohort study with 392 AYA patients and 5373 older adult patients. All the patients were histologically diagnosed gastrointestinal stromal tumors in the Surveillance, Epidemiology, and End Results (SEER) database. The analysis demonstrated that the AYA patients were more likely to undergo surgical management than the older adult patients.
A multivariable analysis of AYA patients demonstrated that non-operative management was associated with a more than 2-fold increased risk of death from GISTs. On subset analysis of 349 AYA patients with tumors of the stomach and small intestine, small-intestine location was associated with improved OS (91.1% compared to 77.2%) and improved GIST-specific survival (91.8% compared to 78.0%). Operative management was associated with improved OS (69.5% compared 53.7%) and improved GIST-specific survival (71.5% compared 56.7%) in a subset analysis of 91 AYA patients with metastatic disease.
1. Fero KE, Coe TM, Fanta PT, et al. Surgical management of adolescents and young adults with gastrointestinal stromal tumors: a US population-based analysis. JAMA Surg. 2017 Jan 18. doi: 10.1001/jamasurg.2016.5047 [Epub ahead of print]