This retrospective, population-based study evaluated the care trajectory and clinical outcome of 1,429 patients diagnosed with a gastrointestinal stromal tumour (GIST) in Belgium between 2012 and 2018. Data from the Belgian Cancer Registry (BCR) were linked to pathology reports, reimbursed medical procedures and medications, and vital status.
The majority (89%) of hospitals treated three or fewer patients per year, on average. Multidisciplinary team (MDT) meetings were billed for 86% of patients, 92% underwent imaging prior to treatment, and 73% received a cyto-/histological diagnosis pre-treatment. Molecular testing was performed in 55% of all patients, increasing to 81% in high-risk cases. Patients were transferred to another hospital in 17% of cases during diagnosis, and another 11% before treatment. Among non-metastatic patients, 88% underwent surgery, with R0 resection achieved in 95% of cases. Tyrosine kinase inhibitors (TKIs) were administered to 92% of metastatic patients (100% in high-volume versus 84% in low-volume hospitals) and 67% of high-risk or R1/R2-resected cases. Unadjusted observed 1- and 5-year survival ranged from 97% to 84% and 90% to 53%, respectively, depending on the risk category.
The diagnostic and therapeutic management of patients with GIST is highly dispersed in Belgium, with the majority of hospitals treating few patients per year. No significant association was found between hospital volume and survival.