Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study.
Epidemiology of gastrointestinal stromal tumors in the era of histology codes: results of a population-based study.
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DOI：
10.1158/1055-9965.epi-14-1002
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Sicklick JK
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文献类型：
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作者：
Ma GL;Murphy JD;Martinez ME;Sicklick JK
迄今为止，所有基于人群的流行病学数据胃肠道间质瘤（GIST）在美国早于2001年实施GIST特异性组织学编码。因此，由于纳入了非GIST腹部或胃肠道肉瘤，既往研究的结果有限。我们利用国家癌症登记处与现代组织学代码，以获得更深入的了解真正的流行病学GIST在美国。我们在监测、流行病学和最终结果数据库中确定了2001年至2011年期间诊断为GIST的6，142例患者。分析发病率、生存率、人口统计学危险因素和预后因素。年龄调整后的年发病率从2001年的0.55/100 000上升到2011年的0.78/100 000，并随着年龄的增长而增加，在70-79奥尔兹之间达到峰值（3.06/100 000）。GIST在男性中也比女性更常见[率比（RR）=1.35]，非西班牙裔比西班牙裔（RR=1.23），黑人（RR=2.07）或亚洲人/太平洋岛民（RR=1.50）比白人。研究期间的5年总体和GIST特异性生存率分别为65%和79%。诊断时有局限性、区域性和转移性疾病的患者的5年总生存率分别为77%、64%和41%。多变量分析表明，诊断时年龄较大、男性、黑人和诊断时晚期是总生存率较差的独立危险因素。多因素分析也显示上述四个特征，沿着早期诊断，是GIST特异性生存率较差的独立危险因素。作为第一个以人群为基础的流行病学研究，组织学证实的疾病，我们的研究结果提供了一个强大的代表性GIST的免疫组化诊断的时代。
To date, all population-based epidemiologic data on gastrointestinal stromal tumor (GIST) in the United States predate the 2001 implementation of GIST-specific histology coding. As such, results from previous studies were limited due to inclusion of non-GIST abdominal or gastrointestinal sarcomas. We utilized a national cancer registry with modern day histological codes to gain greater insight into the true epidemiology of GIST in the United States. We identified 6,142 patients diagnosed with GIST between 2001 and 2011 in the Surveillance, Epidemiology, and End Results database. Incidence, survival, demographic risk factors, and prognostic factors were analyzed. Annual age-adjusted incidence rose from 0.55/100,000 in 2001 to 0.78/100,000 in 2011 and increased with age, peaking among 70-79 year olds (3.06/100,000). GIST was also more common in males than females [rate ratio (RR)=1.35], non-Hispanics than Hispanics (RR=1.23), and blacks (RR=2.07) or Asians/Pacific Islanders (RR=1.50) than whites. The study period had 5-year overall and GIST-specific survival rates of 65% and 79%, respectively. The 5-year overall survival rates for those with localized, regional, and metastatic disease at diagnosis were 77%, 64%, and 41%, respectively. Multivariate analyses demonstrated that older age at diagnosis, male sex, black race, and advanced stage at diagnosis were independent risk factors of worse overall survival. Multivariate analysis also showed the four aforementioned characteristics, along with earlier year of diagnosis, to be independent risk factors of worse GIST-specific survival. As the first population-based, epidemiological study of histologically confirmed disease, our findings provide a robust representation of GIST in the era of immunohistochemical diagnoses.