Pancreatic gastrointestinal stromal tumors: A report of four cases and literature review / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To investigate the clinicopathological features, prognosis and genes mutations of pancreatic gastrointestinal stromal tumors. METHODS: Four cases of pancreatic gastrointestinal stromal tumors were analyzed retrospectively. The cases were diagnosed in Affiliated Hospital of Southwest Medical University from May 2010 to October 2018. PubMed and main domestic databases were searched to retrieve the domestic and foreign literatures for literature review. RESULTS: Including our 4 cases, 59 cases were reported, with 30 males and 29 females. The most common initial symptoms were abdominal pain or discomfort(38 cases, 64.4%), abdominal mass(10 cases, 16.9%) or health examination finds(11 cases, 18.7%). A total of 53 cases were composed of complete imaging and histological type data. CT examination showed that the tumors were more uneven and low-density shadow, with solid-cystic(21 cases,39.7%), solid(20 cases, 37.7%) or cystic(12 cases, 22.6%). The most common histological types were spindle cell type(44 cases, 83.0%), mixed type(7 cases, 13.2%) or epithelioid cell type(2 cases, 3.8%). The rates of 5-year overall survival(OS) and disease-free survival(DFS) were 79.7% and 39.3% respectively. By univariate and multivariate analysis, the main indicator for adverse outcome was mitoses >5/50 HPF(P5/50 HPF is an independent influencing factor of prognosis.Usually, the size of tumor is large and risk is high. C-kit gene mutations are common.