A Gastroenterologist’s Approach to the Diagnosis and Management of Gastrointestinal Stromal Tumors

Davila, Raquel E.

doi:10.1016/j.gtc.2022.06.009

Cited by 5 publications

(5 citation statements)

References 79 publications

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“…Gastrointestinal stromal tumors are common mesenchymal tumors of the gastrointestinal tract. In recent years, with the development of diagnostic techniques, the diagnosis rate of gastric stromal tumors has gradually increased [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic analysis of 2–5 cm diameter gastric stromal tumors with exogenous or endogenous growth

et al. 2023

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Background There has been limited research on the prognosis differences in patients with gastric stromal tumor invasion of the plasma membrane surface. This study intended to investigate whether there is a difference in prognosis in patients with endogenous or exogenous 2–5 cm diameter GISTs. Methods We retrospectively analyzed the clinicopathological and follow-up data of gastric stromal tumor patients, all of whom underwent surgical resection for primary GIST at Nanjing Drum Tower Hospital from December 2010 to February 2022. We classified patients based on tumor growth patterns and then investigated the association between tumor growth patterns and clinical outcomes. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan‒Meier method. Results A total of 496 gastric stromal tumor patients were enrolled in this study, among which 276 patients had tumors of 2–5 cm in diameter. Of these 276 patients, 193 had exogenous tumors, and 83 had endogenous tumors. Tumor growth patterns were significantly related to age, rupture status, resection style, tumor site, tumor size, and intraoperative bleeding. According to Kaplan‒Meier curve analysis, the tumor growth pattern among patients with 2–5 cm diameter tumors was significantly correlated with worse progression-free survival (PFS). Ultimately, multivariate analyses identified the Ki-67 index (P = 0.008), surgical history (P = 0.031), and resection style (P = 0.045) as independent prognostic markers for PFS. Conclusions Although gastric stromal tumors with a diameter of 2–5 cm are classified as low risk, the prognosis is lower for exogenous tumors than for endogenous tumors, and exogenous gastric stromal tumors have a risk of recurrence. Consequently, clinicians should be vigilant regarding the prognosis of patients with this type of tumor.

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Section: Discussionmentioning

confidence: 99%

Prognostic analysis of 2–5 cm diameter gastric stromal tumors with exogenous or endogenous growth

et al. 2023

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“…Among gastric subepithelial lesions, GISTs are the most frequent malignant mesenchymal tumors with variable clinical behavior. [18][19][20] In contrast, leiomyoma, ectopic pancreas, and lipoma are representative benign lesions in the stomach that present as subepithelial lesions. GISTs virtually arise anywhere in the stomach, whereas ectopic pancreas and lipoma develop in the antrum and leiomyoma mostly occur in the cardia.…”

Section: Discussionmentioning

confidence: 99%

“…Among gastric subepithelial lesions, GISTs are the most frequent malignant mesenchymal tumors with variable clinical behavior 18–20 . In contrast, leiomyoma, ectopic pancreas, and lipoma are representative benign lesions in the stomach that present as subepithelial lesions.…”

Section: Discussionmentioning

confidence: 99%

Results of the interim analysis of a prospective, multicenter, observational study of small subepithelial lesions in the stomach

Iwamuro

Mitsuhashi

Inaba

et al. 2023

Digestive Endoscopy

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ObjectivesLong‐term outcomes of gastric subepithelial lesions have not been elucidated. To reveal the natural history, we initiated a prospective, 10‐year follow‐up of patients with small (≤20 mm) gastric subepithelial lesions in September 2014. Here, we report the results of an interim analysis of a prospective observational study.MethodsIn total, 567 patients with 610 lesions were prospectively registered between September 2014 and August 2016. The location, size, morphology, and number of subepithelial lesions were recorded on a web‐based case report form. This study has been conducted as an Academic Committee Working Group of the Japan Gastroenterological Endoscopy Society.ResultsThe endoscopic follow‐up period was 4.60 ± 1.73 years (mean ± standard deviation), and survival data were investigated for 5.28 ± 1.68 years. This interim analysis revealed that the estimated cumulative incidence of a size increase ≥5 mm, after accounting for patients' death and resection of the tumor as competing risk events, was 4.5% at 5 years. In addition, the estimated cumulative incidence of lesion size increase ≥5 mm or resection of lesions was 7.9% at 5 years, and that of size increase ≥10 mm or resection of lesions was 4.5% at 5 years.ConclusionThese results indicate that approximately one in 13 patients with small (≤20 mm) gastric subepithelial lesions may require resection or further investigation for increased tumor size (≥5 mm) within 5 years.

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“…CT and MRI are the tests more commonly used to diagnose GISTs [16]. The risk of postoperative recurrence of GISTs is related to the modified US National Institutes of Health classification.…”

Section: Subepithelial Lesionsmentioning

confidence: 99%

Applications and Prospects of Artificial Intelligence-Assisted Endoscopic Ultrasound in Digestive System Diseases

Huang,

Fan,

Liu

2023

Diagnostics

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Endoscopic ultrasound (EUS) has emerged as a widely utilized tool in the diagnosis of digestive diseases. In recent years, the potential of artificial intelligence (AI) in healthcare has been gradually recognized, and its superiority in the field of EUS is becoming apparent. Machine learning (ML) and deep learning (DL) are the two main AI algorithms. This paper aims to outline the applications and prospects of artificial intelligence-assisted endoscopic ultrasound (EUS-AI) in digestive diseases over the past decade. The results demonstrated that EUS-AI has shown superiority or at least equivalence to traditional methods in the diagnosis, prognosis, and quality control of subepithelial lesions, early esophageal cancer, early gastric cancer, and pancreatic diseases including pancreatic cystic lesions, autoimmune pancreatitis, and pancreatic cancer. The implementation of EUS-AI has opened up new avenues for individualized precision medicine and has introduced novel diagnostic and treatment approaches for digestive diseases.

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A Gastroenterologist’s Approach to the Diagnosis and Management of Gastrointestinal Stromal Tumors

Cited by 5 publications

References 79 publications

Prognostic analysis of 2–5 cm diameter gastric stromal tumors with exogenous or endogenous growth

Prognostic analysis of 2–5 cm diameter gastric stromal tumors with exogenous or endogenous growth

Results of the interim analysis of a prospective, multicenter, observational study of small subepithelial lesions in the stomach

Applications and Prospects of Artificial Intelligence-Assisted Endoscopic Ultrasound in Digestive System Diseases

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