Sex differences in patients with gastrointestinal stromal tumours: do they exist and does it affect survival?

N S IJzerman, E van Werkhoven, M Mohammadi, D den Hollander, R F Bleckman, A K L Reyners, I M E Desar, H Gelderblom, D J Grünhagen, R H J Mathijssen, N Steeghs, W T A van der Graaf*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

BACKGROUND: Sex differences in cancer have gained attention in recent years. The role of sex as a prognostic factor in gastrointestinal stromal tumours (GIST) has not been well established. The aim of this research was to elucidate potential sex differences in GIST patients and the influence of sex on disease-specific survival (DSS).

METHODS: A review of the literature was carried out to obtain an overview of all literature with sex as a covariate on GIST survival analyses. Furthermore, in the Dutch GIST Registry, GIST characteristics between males and females were compared and the influence of sex on DSS was analysed.

RESULTS: A total of 118 articles from the review of the literature met our selection criteria; 58% of the articles found no sex difference in survival and 42% did find a sex difference. All differences favoured female patients, although there was substantial overlap of individual patients in the various reported groups. The Dutch GIST Registry cohort consisted of 1425 patients (46% female). Compared with female patients, male patients had larger tumours (mean 9.0 cm versus 7.9 cm) and higher mitotic rates (34.4% versus 28.0% >5 mitoses/5 mm2). GIST in males was more often metastasized at diagnosis (21.3% versus 13.7%) and incurable (38.5% versus 31.0%). Male patients less often received surgery of the primary tumour (71.7% versus 78.9%), but did experience more tumour ruptures (18.2% versus 13.3%). Male patients had a worse DSS than females. This was not statistically significant when corrected for differences in GIST characteristics.

CONCLUSIONS: In case of sex differences in GIST in the literature, male patients have a worse outcome. In our Dutch GIST cohort a similar finding was made, but sex was shown not to be an independent factor. Male patients more often had aggressive GISTs, with larger tumours, higher mitotic rates, more tumour ruptures, and metastases, which could explain the sex differences in DSS.

Original languageEnglish
Article number100649
JournalESMO Open
Volume7
Issue number6
DOIs
Publication statusPublished - 6 Dec 2022

Bibliographical note

FUNDING
This work was supported by an unrestricted research grant for the Dutch GIST Registry received from Novartis [grant
number 3017/13], Pfizer [grant number WI189378], Bayer [grant number 2013-MED-12005], and Deciphera [grant
number 4EE9EEC-7F19-484D-86A4-646CFE0950A5]. These funding sources did not have any involvement in the conduction of this research.

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

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