Management and prognostic outcomes of gastrointestinal stromal tumors in Sub-Saharan Africa: the central role of surgery in resource-limited settings: a systematic review and meta-analysis (2014-2024)
Abstract
Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. However, data from Sub-Saharan Africa (SSA) remain fragmented, and no prior systematic review has synthesized regional diagnostic and treatment practices.
Methods: We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines (PROSPERO: CRD42024575650). PubMed, Embase, Scopus, Google Scholar, and African Journals Online were searched for studies published between January 2014 and June 2024. Eligible population-, community-, and hospital-based studies reporting on GIST management or prognosis in SSA were included. Study quality was assessed using Joanna Briggs Institute tools. Random-effects models (REML with Hartung-Knapp adjustment) were used to estimate pooled outcomes.
Results: Twenty-one studies comprising 410 patients met inclusion criteria. The median age ranged from 52 to 56 years, and the male-to-female ratio was approximately 1.3:1. The stomach was the most frequent tumor site (64.1%), followed by the small intestine (14.6%). Most patients were symptomatic at diagnosis, with abdominal pain (50.4%) and abdominal mass (47.3%) being the predominant complaints. Computed tomography was the primary imaging modality (99.5%). Surgery was performed in 70% of patients, with R0 resection achieved in 68.2%. Imatinib was used as neoadjuvant (n = 58), adjuvant (n = 64), or palliative therapy (n = 75). Among 199 evaluable patients, the pooled…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 410 participants or records.
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