What Is the Survival Rate for Gastrointestinal Stromal Tumors?

Gastrointestinal stromal tumors have a high survival rate if the cancer is caught early; 94% of people diagnosed with localized GI stromal tumors are alive five years later.

Gastrointestinal stromal tumors (GISTs) are uncommon cancers that occur when special cells in the wall of the gastrointestinal (GI) tract (the digestive tract) start to grow out of control.

More than half of all GISTs begin in the stomach, and most of the others start in the small intestine. 

What Are Symptoms of Gastrointestinal Stromal Tumors?

Most gastrointestinal stromal tumors (GISTs) develop within the wall of the stomach or small intestine and might not cause symptoms early on.

When symptoms of gastrointestinal stromal tumors occur, they may include: 

• Symptoms related to blood loss
  • Bleeding from the GI tract can be serious. See a doctor if you have any of the following symptoms: 
    • Vomiting blood (may look like coffee grounds)
    • Black and tarry stools
    • Stools that are visibly red with blood
    • Anemia (tiredness, weakness)
• Abdominal pain
  • Severe abdominal pain may be a sign of blockage in the stomach or intestine (obstruction) or a hole in the wall of the GI tract (perforation)
  • These can be medical emergencies; see a doctor if you have severe abdominal pain
• Abdominal mass or swelling 
• Nausea 
• Vomiting
• Feeling full after eating only a small amount of food
• Loss of appetite
• Weight loss
• Problems swallowing (for tumors in the esophagus)

Gastrointestinal stromal tumors (GISTs) are caused by genetic changes, though the reason these changes occur is unknown. 

Risk factors for developing gastrointestinal stromal tumors include: 

• Age: more common in people over 50 years and rare in people younger than 40
• Certain inherited genetic syndromes
  • Primary familial GIST syndrome
  • Neurofibromatosis type 1 (von Recklinghausen disease)
  • Carney-Stratakis syndrome

Gastrointestinal stromal tumors (GISTs) are diagnosed with a physical exam, a patient history, and tests including: 

• Imaging tests
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI) scan
  • Barium X-rays
    • Barium swallow
    • Upper GI series
    • Enteroclysis
    • Barium enema (also known as a lower GI series) 
  • Positron emission tomography (PET) scan
• Endoscopy
  • Upper endoscopy
  • Colonoscopy (lower endoscopy)
  • Capsule endoscopy
  • Double balloon enteroscopy 
  • Endoscopic ultrasound (EUS)
• Biopsy
  • Endoscopic biopsy
  • Needle biopsy
  • Surgical biopsy
  • Lab tests of biopsy samples 
    • Immunohistochemistry
    • Molecular genetic testing
    • Mitotic rate
• Blood tests
  • Complete blood count (CBC)
  • Liver function tests 

Treatment for gastrointestinal stromal tumors (GISTs) may include one or more of the following: 

• Surgery 
  • Small tumors can often be removed along with a small area of normal tissue around it
  • For large tumors or those that grow into other organs, the tumor may be able to be removed entirely, though parts of organs (such as a section of the intestines) might need to be removed
  • Surgery is not a common treatment for a GIST that has spread (metastasized) to other parts of the body
• Targeted drug therapy using tyrosine kinase inhibitors (TKIs)
  • Imatinib (Gleevec)
  • Sunitinib (Sutent)
  • Regorafenib (Stivarga)
  • Ripretinib (Qinlock)
  • Avapritinib (Ayvakit)
  • Other tyrosine kinase inhibitors being studied 
    • Sorafenib (Nexavar)
    • Nilotinib (Tasigna)
    • Dasatinib (Sprycel)
    • Pazopanib (Votrient)
• Ablation 
  • Radiofrequency ablation (RFA) uses high-energy radio waves to heat the tumor and destroy cancer cells
  • Ethanol (alcohol) ablation in which concentrated alcohol is injected directly into the tumor to kill cancer cells
  • Microwave thermotherapy, where microwaves transmitted through a probe placed in the tumor are used to heat and destroy the cancer cells
  • Cryosurgery (cryotherapy), which destroys a tumor by freezing it using a thin metal probe
• Embolization 
  • A procedure in which the doctor injects substances to try to block or reduce the blood flow to cancer cells in the liver
    • Arterial embolization (also known as trans-arterial embolization or TAE)
    • Injecting tiny radioactive spheres into the hepatic artery (radioembolization)
    • Giving chemo directly into the artery just before plugging it up (chemoembolization)
• Chemotherapy 
  • GISTs rarely shrink in response to these drugs, so traditional chemo is rarely used 
• Radiation therapy 
  • Radiation is not very helpful in treating gastrointestinal stromal tumors (GISTs), so it is not used often
  • Sometimes it is used to relieve symptoms such as bone pain

Life expectancy for gastrointestinal stromal tumor (GIST) is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis.  

Gastrointestinal stromal tumor 5-year survival rates: 

• Localized (cancer is limited to the organ where it started, for example, the stomach, small intestine, or esophagus): 94% 
• Regional (cancer has grown into nearby structures or spread to nearby lymph nodes): 82% 
• Distant (cancer has spread to distant parts of the body such as the liver): 52%