Do variations in prognostic risk stratification criteria for patients with gastrointestinal stromal tumours affect adjuvant treatment?

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Published: 5 Jul 2017
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Dr Fahad Ibnshamsah - King Fahad Specialist Hospital, Dammam, Saudi Arabia

Dr Ibnshamsah talks with ecancer at ESMO GI 2017 about gastrointestinal stromal tumour and the retrospective study looking into the decisions being made for adjuvant therapy according to the armed forces institute of pathology’s criteria for risk stratification.

The study title is ‘Do variations in prognostic risk stratification affect treatment plans in gastrointestinal stromal tumours?’ It was a retrospective study, we reviewed our patients from 2011 to 2016. We found 34 patients of gastrointestinal tumour, 28 of them got surgery and adjuvant treatment. So we used the AFIP, Armed Forces Institution of Pathology, risk stratification to decide about adjuvant treatment. We were wondering would using another criteria affect this decision of treatment with adjuvant imatinib. So we thought we’d convert this to the modified National Institution of Health, NIH, scoring system and the main difference in our study was between the high risk group and the moderate risk group or intermediate within NIH. That was different but did not affect actually the treatment plan because both moderate and high risk patients will get adjuvant imatinib.

Only one patient who was stratified as no risk in the Armed Forces Institution of Pathology scoring system would have been moderate risk in the NIH and would have been given adjuvant imatinib. One patient was not a significant difference but we thought in our conclusion of the study that these stratification risk systems should be used with caution.

What were the outcomes of the study?

Our conclusion of the study and message is that both AFIP and NIH are validated, of course, and useful tools to decide about adjuvant treatment. However, they should be used with caution and probably genotyping will be potentially useful in the future.