P4184 - Factors Associated With Poor Prognosis in Patients Diagnosed With GIST Over the Past Decade in the United States

Vignesh Krishnan Nagesh, MD¹, Pierre Fwelo, MPH², Shraboni Dey, MD¹, Stacy Lee, MD, MPH¹, Amer Jarri, MD¹, Imranjot Singh Sekhon, MD¹, Bilal Niazi, MD¹, Chinmay Trivedi, MD¹, Ayrton Bangolo, MD¹, Syed Sirajuddin, MD¹, Sameh Elias, MD¹, Adam Atoot, MD¹, Simcha Weissman, DO^1
1Hackensack Meridian Palisades Medical Center, North Bergen, NJ; ²UT Health Houston, Houston, TX

Introduction: Gastrointestinal stromal tumors (GIST) are rare mesenchymal neoplasms of the GIT that represent approximately 1 to 2 percent of primary gastrointestinal (GI) cancers. Owing to their rarity, very little is known about the overall epidemiology and prognostic factors of the pathology. The purpose of this study is to investigate the clinical characteristics, survival outcomes, and independent prognostic factors of patients with GIST in the past decade.

Methods: A total of 2,374 patients diagnosed with GIST, between 2000 and 2017, were ultimately enrolled in our study by retrieving the Surveillance, Epidemiology, and End Results (SEER) database. We analyzed demographics, clinical characteristics, and overall mortality (OM) as well as cancer-specific mortality (CSM) of GIST. Variables with a p value < 0.01 in the univariate Cox regression were incorporated into the multivariate Cox model to determine the independent prognostic factors, with a hazard ratio (HR) of greater than 1 representing adverse prognostic factors.

Results: Multivariate cox proportional hazard regression analyses of factors affecting all-cause mortality and GIST related mortality among US patients between 2010 and 2017 revealed higher overall mortality in Non-Hispanic Blacks (HR= 1.516, 95% CI 1.172-1.961, p= 0.002), age 80+ (HR= 9.783, 95% CI4.185-22.868, p= 0); male patients (HR= 1.795 , 95% CI 1.461-2.206, p=0); advanced disease with distant metastasis (HR= 3.865 , 95% CI 2.977-5.019, p=0), and widowed patients (HR= 1.975, 95% CI 1.494-2.61, p= 0). The highest CSM was observed in the same groups, except widowed patients and patients aged 60-79. The highest CSM was also observed among patients that underwent chemotherapy (HR= 1.687, 95% CI 1.19-2.392, p= 0.003).

Discussion: In this United States population-based retrospective cohort study using the SEER database, we found that non-Hispanic blacks, male patients, and patients older than 60 years have a higher mortality with GIST. Furthermore, patients who received chemotherapy have a higher GIST specific mortality and married patients had a lower mortality. The results of this study may help treating clinicians to identify patient populations associated with dismal prognosis as those may require closer follow-up and more intensive therapy; furthermore, with married patients having a better survival, we hope to encourage clinicians to involve family members of the affected patients early in the disease course as the social support might impact the prognosis.


Disclosures:


Vignesh Krishnan Nagesh, MD¹, Pierre Fwelo, MPH², Shraboni Dey, MD¹, Stacy Lee, MD, MPH¹, Amer Jarri, MD¹, Imranjot Singh Sekhon, MD¹, Bilal Niazi, MD¹, Chinmay Trivedi, MD¹, Ayrton Bangolo, MD¹, Syed Sirajuddin, MD¹, Sameh Elias, MD¹, Adam Atoot, MD¹, Simcha Weissman, DO¹. P4184 - Factors Associated With Poor Prognosis in Patients Diagnosed With GIST Over the Past Decade in the United States, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.