Gastrointestinal stromal tumour in the elderly

Aim: To analyze the outcome of elderly patients compared with the younger age group patients who were diagnosed with gastrointestinal stromal tumours (GIST) at our institution. Methods: Patients diagnosed with GISTs were analyzed according to two age groups, those who were at least age 65 and less than age 65. Results: A total of 49 patients were reviewed. Median age at diagnosis was 59. 18 patients (36.7%) were of age at least 65 or above. Of these 11 patients presented with localized disease. Five patients subsequently developed recurrence with metastatic disease. The median recurrence free survival was 18.5 months. This was not significantly different compared to the younger age group patient (P=0.598). On univariate analysis, the presence of co-morbidities was found to be significantly associated with decrease recurrence-free survival (P = 0.046). 13 patients (72.2.%) of the elderly age group had metastatic disease. 8 of these patients had metastasis at diagnosis and 5 developed metastasis at recurrence. The median progression-free survival for these patients was 33 months and there was no significant difference compared to the younger age group patient (P = 0.887). On univariate analysis, low albumin was associated with low progression survival (P = 0.047). The median overall survival for the elderly patients was 37.6 months. There was no significant difference compared to the younger age group patient (P = 0.119). Presence of co-morbidity was associated with lower overall survival in the elderly age group in the multivariate analysis (P = 0.037). Conclusion: The elderly with GIST can achieve a similar outcome as younger patients. Presence of co-morbidity was found to affect the survival of elderly patients with GIST. (C) 2008 Elsevier Ireland Ltd. All rights reserved.