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Open Access Research article

The epidemiology of gastrointestinal stromal tumors in Taiwan, 1998–2008: a nation-wide cancer registry-based study

Nai-Jung Chiang12, Li-Tzong Chen1234*, Chia-Rung Tsai1 and Jeffrey S Chang1*

Author Affiliations

1 National Institute of Cancer Research, National Health Research Institutes, 2 F, No. 367, Sheng Li Road, Tainan 70456, Taiwan

2 Division of Hematology/Oncology, Department of Internal Medicine, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 70456, Taiwan

3 Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100, Ziyou 1st. Road, Sanmin District, Kaohsiung 807, Taiwan

4 School of Pharmacy, College of Pharmacy, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan

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BMC Cancer 2014, 14:102  doi:10.1186/1471-2407-14-102

Published: 18 February 2014

Abstract

Background

To investigate the incidence of gastrointestinal stromal tumors (GISTs) in Taiwan and the impact of imatinib on the overall survival (OS) of GIST patients.

Methods

GISTs were identified from the Taiwan Cancer Registry (TCR) from 1998 to 2008. The age-adjusted incidence rates and the observed OS rates were calculated. Cox proportional hazards models were applied to examine the mortality risk in three time periods (1998–2001, 2002–2004, 2005–2008) according to the application and availability of imatinib.

Results

From 1998 to 2008, 2,986 GISTs were diagnosed in Taiwan. The incidence increased from 1.13 per 100,000 in 1998 to 1.97 per 100,000 in 2008. The most common sites were stomach (47-59%), small intestine (31-38%), and colon/rectum (6-9%). The 5-year observed OS was 66.5% (60.3% for men, 74.2% for women, P < .0001). GISTs in the stomach had a better 5-year observed OS (69.4%) than those in the small intestine (65.1%) (P < .0001). The outcome of GIST improved significantly after the more widespread use of imatinib; the 5-year observed OS increased from 58.9% during 1998–2001 to 70.2% during 2005–2008 (P < .0001). Younger age, female sex, stomach location, and later diagnostic years were independent predictors of a better survival.

Conclusions

The incidence of GIST has been increasing in Taiwan, partially due to the advancement of diagnostic technology/method and the increased awareness by physicians. The outcome of GIST has improved significantly with the availability and the wider use of imatinib.

Keywords:
Gastrointestinal stromal tumors; Incidence; Imatinib; Survival