Gastrointestinal Stromal Tumors: From Diagnosis to Adjuvant Therapy

Abstract

Gastrointestinal stromal tumors (GISTs) represent a very rare form of digestive tract cancer belonging to the sarcoma family. The aim of this study is to establish the epidemiological profile, diagnostic challenges, and therapeutic difficulties of this malignant tumor in a developing country. A retrospective study, spanning 4 years from 2020 to 2023, was conducted in the Gastroenterology Department I at HMIMV in Rabat, identifying 37 cases of stromal tumors. The average age of our patients was 58 years. The average duration of disease progression was 4 months. Biopsy confirmed the diagnosis in 19 cases and surgery in 18 cases. The main histological form was spindle-shaped (67.6%). The GISTs in our series had an average tumor size of 8.4 cm, with C-Kit positivity in 36 cases. The risk of recurrence was established for all patients, with 17 being at high risk. In the staging evaluation, the tumor was localized in 83.8% of cases, locally advanced in 8.1%, and metastatic in 8.1%. Surgery was the primary treatment for the patients in our study. Drug treatment with imatinib was prescribed for 24 out of 37 patients in the series, accounting for 62.2% of cases. With an average follow-up of five years, the mean survival rate was over 70% at five years, with complete remission in 62.2% of cases, partial remission in 6.3%, tumor recurrence in 9.4%, and death in 15.6% of cases.