BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common 
mesenchymal tumours of the gastrointestinal tract and make up 1-2% of all 
gastrointestinal malignancies. Traditionally, the treatment of choice for 
primary disease is surgical resection; however, no single surgeon or institution 
gets extensive exposure to these patients so appropriate decision-making is 
difficult, particularly since the introduction of the tyrosine kinase inhibitor 
imatinib, which has become an important additional management tool.
METHOD: All patients were diagnosed and treated for GISTs in Christchurch 
Hospital (Christchurch, New Zealand) between 1 January 2000 and 31 December 
2010. We maintain a prospective database of all patients with GISTs. Data on 
clinical and histopathological variables, management and survival outcomes were 
recorded. These were then reviewed.
RESULTS: There were 93 patients in this study. Fifty were women. Median age was 
69 (interquartile range (IQR) 59-76) years. Fifty-one tumours were located in 
the stomach, 27 in the small bowel, six in the colon, three in the oesophagus, 
one in the rectum and five were extra-gastrointestinal. In total, 22 patients 
received imatinib therapy; four patients with metastatic disease had imatinib as 
sole therapy. The median follow-up was 58 (IQR 30-90) months. The 5-year overall 
survival and disease-free survival (DFS) for the entire study population was 69% 
and 64%, respectively. The 5-year DFS was higher for all patients who have 
localized disease when compared with those who have metastatic disease (76% 
versus 28%, P-value 0.001).
CONCLUSION: Surgery aiming at an R0 resection remains the mainstay of treatment. 
We propose the most effective way to grow the knowledge base in New Zealand is 
the establishment of a national register, thereby allowing better clinical 
decision-making by interpretation of a larger data set.