Comprehensive review into the challenges of gastrointestinal tumors in the Gulf and Levant countries

Farhat, Fadi; Farsi, Abdulaziz Al; Mohieldin, Ahmed; Bahrani, Bassim Al; Sbaity, Eman; Jaffar, Hassan; Kattan, Joseph; Rasul, Kakil Ibrahim; Saad, Khairallah; Assi, Tarek; Morsi, Waleed El; Abood, Rafid A.

doi:10.12998/wjcc.v8.i3.487

Cited by 4 publications

(5 citation statements)

References 85 publications

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“…As the pathogenic mechanisms of GIST have been well elucidated, the TKI imatinib mesylate, the 1st TKI-targeted drug imatinib mesylate has dramatically improved the clinical outcomes of GIST patients and has become the preferred treatment for locally advanced rectal GIST ( 5 ). It is currently believed that preoperative treatment can be performed for rectal GIST for which it is difficult to achieve R0 resection or for those with a high surgical risk, a large size, and that require combined organ resection.…”

Section: Discussionmentioning

confidence: 99%

“…The advent of tyrosine kinase inhibitors (TKIs) and development of molecular testing in recent decades has dramatically changed the treatment paradigm for GIST. Today, radical surgical resection combined with targeted therapy has become a standard treatment modality for GIST ( 5 ). From the Consensus on the diagnosis and treatment of gastrointestinal stromal tumors in China (2008 edition) ( 6 ) to the Expert consensus on the diagnosis and treatment of gastrointestinal stromal tumors in China (2011 edition) ( 7 ), to the Consensus on the diagnosis and treatment of gastrointestinal stromal tumors in China (2013 edition) ( 8 ), to the Chinese consensus guidelines for diagnosis and management of gastrointestinal stromal tumor (2017 edition) ( 9 ), and to the latest the Chinese expert consensus on whole-process management of gastrointestinal stromal tumor (2020 edition) ( 10 ), it can be seen that the development of the treatment concept of GIST in China has changed from the old traditional management model to the whole-process management, which indicates that multidisciplinary team (MDT) in the management of GIST is an inevitable product of the development of the era of precision treatment.…”

Section: Introductionmentioning

confidence: 99%

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Rectal gastrointestinal stromal tumor with metachronous liver metastasis demonstrated no relapse after multidisciplinary team discussion and comprehensive treatment: a case report

Zhang¹,

Cai²,

Deng³

et al. 2022

J Gastrointest Oncol

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Background: This study sought to explore the role and significance of multidisciplinary team (MDT) discussion and comprehensive treatment in the diagnosis and treatment of a gastrointestinal stromal tumor (GIST) with liver metastasis. For GIST patients with liver metastasis, MDT can evaluate whether the liver metastasis is resectable, so as to formulate accurate treatment goals and the best diagnosis and treatment plan.Case Description: A 53-year-old male patient with localized rectal GIST with metachronous liver metastasis (MLM) was admitted to Yunnan Cancer Hospital in October 2014. At the 1st visit, he was diagnosed with locally advanced rectal GIST, and a MDT discussion was held by departments of colorectal surgery, imaging, pathology and oncology. The tumor shrank after neoadjuvant targeted treatment with imatinib. A local resection of the rectal GIST was successfully performed via the anal approach. R0 resection was achieved and the function of the anal sphincter was preserved. Following the operation, oral imatinib treatment was discontinued after 2 years. The patient developed isolated liver metastasis 6 months later. After the MDT discussion by departments of colorectal surgery, hepatobiliary surgery, imaging, pathology, and oncology, R0 resection of the liver metastasis was achieved. After the operation, sunitinib was administered for 4.5 years. The patient's overall survival (OS) has reached 7.5 years. No tumor recurrence or metastasis was found in the re-examinations. The follow-up is ongoing.Conclusions: Targeted therapy combined with surgery is the most suitable way to cure GIST patients with liver metastasis. More importantly, the multi-disciplinary management and the standardized diagnosis and treatment of GIST patients with liver metastasis through MDT discussion can improve the quality of life and prolong the survival of patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rectal gastrointestinal stromal tumor with metachronous liver metastasis demonstrated no relapse after multidisciplinary team discussion and comprehensive treatment: a case report

Zhang¹,

Cai²,

Deng³

et al. 2022

J Gastrointest Oncol

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show abstract

“…Magnetic resonance imaging (MRI) provides similar information as CT but may be more accurate in identifying anorectal GISTs and metastatic hepatic GISTs. On MRI, GISTs typically show low to intermediate signal intensity on T1-weighted images and are hyperintense on T2-weighted images [ 11 - 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 70-80% of GISTs co-express CD34; however, it is less sensitive and specific. GISTs may also be positive for smooth muscle actin in 30-40% of the cases and may rarely be positive for S100 protein (Schwann cell marker), desmin (smooth muscle marker), and keratin [ 4 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Stromal Tumor: An Uncommon but Serious Cause of Gastrointestinal Bleeding

et al. 2021

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Gastrointestinal stromal tumors (GISTs) are rare tumors of the GI tract that can sometimes present as a gastrointestinal bleeding source. This report describes a patient presented with upper GI bleeding secondary to a gastric GIST, which was initially detected on endoscopy. The patient underwent surgical resection of the tumor and was started on adjuvant chemotherapy with imatinib. The patient’s postoperative course was complicated by an esophageal leak requiring re-exploratory laparotomy and esophageal stent placement. The stent was removed 5 weeks later and the patient remained stable for discharge after 60 days of inpatient care.

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“…[ 8 ] Histopathologically, it can be classified as epithelioid, spindle cell, or mixed type, and prognostic indices depend on tumor sizes such that tumors with size >5 cm with mitotic figures >5/50 high-power fields (HPF), or tumor sizes >10 cm with any mitosis, or regardless of size with >10/50 HPF indicate malignant behavior. [ 21 , 22 ]…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological and Immunohistochemical Characterization of Gastrointestinal Stromal Tumour at Four Tertiary Health Centers in Nigeria Using CD117, DOG1, and Human Epidermal Growth Factor Receptor-2 Biomarkers

Rasheed,

Abiodun,

Eziagu

et al. 2023

Annals of African Medicine

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Aims: Gastrointestinal stromal tumors (GISTs) are neoplastic lesions that primarily affect the digestive tract and develop from interstitial cells of Cajal. These lesions require histopathological and immunohistochemical characterization due to their malignant potential and personalized treatment. In this investigation, the sex, age, lesional sites of origin, histopathological types, the prevalence of human epidermal growth factor receptors (HER-2) expression, prognostic indices (based on tumor size and mitotic figures), expression of CD117 and DOG1, and characteristics of patients with GIST were all characterized. Materials and Methods: This was a retrospective cross-sectional analysis of GIST cases seen at four tertiary health-care centers in Nigeria over a 10-year period (2008–2017) and investigated utilizing histopathological and immunohistochemical (CD117, DOG1, and HER-2) methods. Results: In this investigation, there were twenty GIST cases. Notably, the majority (40%) of the cases had tumors with sizes between 7.0 and 8.0 cm; the stomach was the most frequent site (70%) and the spindle cell type of GIST was the most prevalent (80%) histopathological type. In addition, the stomach was significantly associated with GIST as an origin site (with a P = 0.001), and 100% and 50% of these tumors were immunoreactive with CD117 and DOG1, respectively. Conclusions: In our study, GISTs most frequently develop in the stomach, and CD117 and DOG1 are essential for correctly diagnosing these tumors. However, HER-2 immunoreactivity is a predictive marker of survival for personalized care.

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Comprehensive review into the challenges of gastrointestinal tumors in the Gulf and Levant countries

Cited by 4 publications

References 85 publications

Rectal gastrointestinal stromal tumor with metachronous liver metastasis demonstrated no relapse after multidisciplinary team discussion and comprehensive treatment: a case report

Rectal gastrointestinal stromal tumor with metachronous liver metastasis demonstrated no relapse after multidisciplinary team discussion and comprehensive treatment: a case report

Gastrointestinal Stromal Tumor: An Uncommon but Serious Cause of Gastrointestinal Bleeding

Clinicopathological and Immunohistochemical Characterization of Gastrointestinal Stromal Tumour at Four Tertiary Health Centers in Nigeria Using CD117, DOG1, and Human Epidermal Growth Factor Receptor-2 Biomarkers

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