Patients with Gastrointestinal Tumors at Higher Risk of Other Cancers

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Researchers at UC San Diego School of Medicine conducted the first population-based study that characterizes the association and temporal relationship between gastrointestinal stromal tumors (GIST) and other cancers. The results, published by Cancer on April 30, indicate that one in 5.8 patients with GIST will develop additional malignancies before and after their diagnosis.

Specifically, patients with GIST are more likely to develop other sarcomas, non-Hodgkin’s lymphoma, carcinoid tumors, melanoma, colorectal, esophageal, pancreatic, hepatobiliary, non-small cell lung, prostate and renal cell cancers.

“Only 5 percent of patients with gastrointestinal stromal tumors have a hereditary disorder that predisposes them to develop multiple benign and malignant tumors,” said Jason K. Sicklick, MD, assistant professor of surgery and UC San Diego Moores Cancer Center surgical oncologist. “The research indicates that these patients may develop cancers outside of these syndromes, but the exact mechanisms are not yet known.”

The researchers said further studies are needed to understand the connection between GIST and other cancers, but the findings may have clinical implications.

“Patients diagnosed with gastrointestinal stromal tumors may warrant consideration for additional screenings based on the other cancers that they are most susceptible to contract,” said co-author James D. Murphy, MD, assistant professor of radiation oncology and UC San Diego Moores Cancer Center radiation oncologist.

When compared to the United States population, the researchers found that people with GIST had a 44 percent increased prevalence of cancers occurring before a GIST diagnosis and a 66 percent higher risk of developing cancers after diagnosis. The most common tumors were those of the genitourinary tract, breast, respiratory and blood.

Non-Hispanic patients had a higher incidence of other cancers before a GIST diagnosis. Patients whose tumors were smaller than 10 centimeters had a higher probability of a second cancer than patients whose growth was larger. People with tumors smaller than 2 cm had the greatest likelihood of developing additional malignancies, both before and after diagnosis.

Co-authors include Grace L. Ma, Joel M. Baumgartner, Lisa Madlensky, Adam M. Burgoyne, Chih-Min Tang and Maria Elena Martinez, all at UC San Diego Moores Cancer Center.

Funding for this research came, in part, from the National Institutes of Health (KL2 RR031978 and K08 CA168999), the GIST Research Fund and a UC San Diego Academic Senate Health Sciences Research Grant.