Clinicopathological features and outcome of gastrointestinal stromal tumors in an Afro-Caribbean population.

Objective: A retrospective observational study was done to describe the clinical and pathological profile of gastrointestinal stromal tumors (GISTs) in Afro-Caribbean patients at a tertiary care referral center over a 5-year period.

Results: Eighteen cases of GIST were identified over the period under review. Male to female ratio was 1.25:1, the mean age was 54.7 years, and abdominal pain (44%) and gastrointestinal bleeding (50%) were the predominant presenting symptoms. The majority of tumors were of gastric location (83%) and spindle cell morphology (66%). C-kit (CD117) positivity was found in 13 of 14 (93%) cases tested. Using current guidelines for assigning risk of aggressive behavior, 44% of tumors were considered high risk. Of the 10 patients with high-risk or intermediate-risk tumors, 4 died, 1 of which had developed resistance to imatinib therapy.

Conclusion: In this group of patients, GISTs demonstrated predominantly gastric location and spindle cell morphology and a guarded outlook for more aggressive tumors, which is moderated in the long-term by imatinib resistance.