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Researchers Found a Relationship Between GISTs and Peritoneal Mesothelioma

Published: August 12, 2022

Scientists may have found an easy way to identify peritoneal mesothelioma, making it easier to detect and catch the cancer earlier. These researchers may have found a link between peritoneal mesothelioma and gastrointestinal stromal tumors. The research done in the division of surgical oncology at University of California San Diego Moores Cancer Center found a co-occurrence between the two illnesses. In July, results were posted in the Annals of Surgical Oncology showing that 17 patients receiving surgery for gastrointestinal stromal tumors (GISTS) also had peritoneal mesothelioma cells nearby. This information could lead to future adjuvant therapies for both diseases, but for now it could lead to advances in the diagnostics of the two cancers.

Gastrointestinal stromal tumors, or GISTS, are a cancer that forms in the stomach and small intestines. They can be found by the nerve cells and the walls of organs. They are usually found in seven people per million in the United States and scientists believe that the cancer is potentially caused by genetics. GISTS are usually found in 14 to 33 percent of patients with other cancers, but researchers never looked at the relationship between mesothelioma and GISTS. Peritoneal mesothelioma is a very rare cancer. Around 2 cases per million people are diagnosed in the United States every year because of asbestos exposure. It occurs more often in people with the Bap-1 gene mutation.

There were 137 patients from the years 2010 through 2021 who had GIST resection. Eight of the people receiving the surgery had peritoneal mesothelioma. All the patients’ tumors were surgically removed. At a median 14 month follow up, the eight patients did not have GIST recurrence. One patient had recurrence after five months despite the cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment. Researchers believe that the high levels of cooccurrence of GISTs and peritoneal mesothelioma could mean that there is a local, non-independent symbiotic relationship between the two cancers.

Patients with gastrointestinal stromal tumors had a median age of 57 years. Four of the eight patients in the study had a history of other cancers or benign tumors. Six of the eight patients had mesothelioma nodules near the GISTs. A lack of awareness may be the cause for the underreporting of the co-occurrence of GIST and mesothelioma tumors. Researchers believe doctors need to know about the relationship between GISTs and mesothelioma tumors before performing surgery so all cancerous tissue can be removed. If caught early enough, treatments like cytoreductive surgery and intraoperative chemotherapy can lead to survival of five to 10 years or even more for patients with peritoneal mesothelioma. Early detection is not common though so many patients receive treatment that is not effective, leading to patients’ cancer coming back sooner.

Asimina S. Courelli MD et al., “Co-Localization of Gastrointestinal Stromal Tumors (GIST) and Peritoneal Mesothelioma: A Case Series” Annals of Surgical Oncology (July 18, 2022). [Link]
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