الفهرس 
C -Kit negative Gastrointestinal Stromal Tumor, Challenges Of Management And Prognosis
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Abstract
Patients: This is a retrospective descriptive analysis involving All patients with GIST who were diagnosed and treated at the National Cancer Institute, Cairo University, during the period from January 2011 till December 2020.
Methods: criteria of patients & operative data & pathology reports & target therapy used
Results: This retrospective cohort study included 138 cases of GIST, 22 case were ckit negative with a ratio 15.9%. The mean age of ckit negative patients was 54.9. years. Male to female incidence ratio of ckit negative was 1:1. GIST Ckit negative presented as pelvi-abdominal mass of unspecified origin(n=7) 31.8%, liver (n=6) 27.2%, stomach (n=5) 22.7%, colo-Rectal (n=4) 18.2 %. The size of the tumor of GIST Ckit negative ranged from (2-25) cm, median: 11.5 cm and the mitotic count: 2-60 per 50 HPF. The positive markers in these cases were CD 34: 27.3 %, Actin:22.7 %, Dog1: 22.7 %, PDGFR: 13.6%. Surgery was the main line of treatment with ratio 68.2 %. 9 out of 22 cases received adjuvant target therapy (imatinib) only beside surgery. Overall survival of cases who underwent for surgical intervention was 48 months while Surgery with target therapy (Imatinib) 40% of ckit negative show high overall survival 54 months. Recurrence in GIST ckit negative was 68 % with median overall survival 28 months. liver was most common site for recurrence 59 %.
Overall survival of GIST ckit negative cases was low (median:30 months) in comparison to ckit positive (median: 60 months).
Conclusion: GIST ckit negative incidence are less common than ckit positive and equal in both male &female gender. Age of 50’s is the most common age of incidence. ckit negative can be diagnosed in absence of kit marker by IHP by another markers mainly (DOG1, Actin, CD 34 and PDGFR).Despite of resistance of target therapy in case of ckit negative GIST, the study results show patients whom received imatinib had high OS in comparison to those who didn’t receive. this revealed not all cases of GIST ckit negative are resistant to imatinib and cases may get benefit from imatinib. still surgery is the main line of treatment for resectable tumor with a good 5 years OS up to 40 %.