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Bone Metastases of Gastrointestinal Stromal Tumor: A Review of Published Literature

Authors Yang J, Yan J, Zeng M, Wan W, Liu T, Xiao JR

Received 30 September 2019

Accepted for publication 20 January 2020

Published 26 February 2020 Volume 2020:12 Pages 1411—1417


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Chien-Feng Li

Jian Yang,1,* Jijie Yan,2,* Meihui Zeng,3,* Wei Wan,1 Tielong Liu,1 Jian-Ru Xiao1

1Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, People’s Republic of China; 2Ningbo University, Ningbo, Zhejiang, People’s Republic of China; 3Department of Neurosurgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Tielong Liu; Jian-Ru Xiao
Tel +8602181885634
Fax +8602163720099

Background: With the occurrence and improvement of immunohistochemistry and other pathological diagnostic techniques, gastrointestinal stromal tumor (GIST) has been gradually recognized. With the prolonged survival of patients with GISTs, reports about the bone metastasis of GIST increased. However, the knowledge of GISTs is rather limited due to its very low incidence.
Methods: Cochrane and Medline database (via PubMed) were searched in July 2019 with related keywords to acquire the literature related to the bone metastasis of GIST. Then, the literature was reviewed and references were also scanned to identify the possible related reports. Study data comprising age, sex, primary location, metastasis interval time, immunohistochemistry index, management and prognosis were recorded and analyzed.
Results: Forty-five patients with bone metastases of GIST, with a mean age of 61.09 years, were included. The small intestine and stomach were the most common primary sites, followed by the rectum. Patients with small intestine primary sites had bone metastases that occurred earlier than the bone metastases stomach and rectum primary sites. The spine was the most common site of bony metastases. The mean survival time after GIST diagnosis was more than 64.02 months. Patients younger than 60 years old had a worse prognosis than those older than 60 years old. Furthermore, patients with spinal involvement had a worse prognosis than those without spinal involvement. Surgical interventions combined with targeted therapies guaranteed a better prognosis.
Conclusion: Bone metastasis of GIST, which mainly occurs in the spine, is rather rare. Patients with GISTs of the small intestine and stomach suffered from bone metastasis more frequently and earlier than patients with GISTs in other primary sites. Age, sex, primary tumor location, treatment mode for the primary lesions and metastases, and spine involvement may be potential factors that affect the prognosis of GIST patients with bone metastases.

Keywords: gastrointestinal stromal tumor, bone metastasis, tyrosine kinase inhibitors, prognosis

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