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A Retrospective Study of the Incidence of GIST in Scotland from 1995 to 1999

Graham JS, Nowicki S, Dunbar G, Cowie F, Dick C, R Reid, Walsh S, White JD and Boyd K

Background and aims: Gastrointestinal Stromal Tumours (GIST) are mesenchymal soft tissue neoplasms which express the c-kit receptor and are exquisitely sensitivity to tyrosine kinase receptor inhibitors such as imatinib. This has significantly improved prognosis so it is important to identify retrospective cases. Methods: Patients between 1995-1999 with suspected GIST were identified via Scottish pathology departments. C-kit + and C-kit -/CD34 + tumours were included. Data were analysed according to NIH consensus and the newer AFIP criteria. Results: The incidence of GIST was 0.69/100000/year. 44.8% were originally diagnosed as GISTs. Using NIH Consensus criteria there was a statistically significant relationship between overall survival and necrosis (p=0.004), prognostic group (p<0.0001) and mitotic rate (p=<0.0001). Overall survival was correlated with AIFP criteria (p value <0.0001). Conclusion: This pan Scotland study validates the AFIP criteria for assessment of overall survival in GISTs. In addition using the established NIH consensus criteria confirms a similar incidence to other European countries. We have identified patients who are eligible for targeted therapies who would otherwise have been missed.