Gastrointestinal Stromal Tumor

Sharma, Ashwyn K.; Kim, Teresa S.; Bauer, Sebastian; Sicklick, Jason K.

doi:10.1016/j.soc.2022.03.007

Cited by 9 publications

(3 citation statements)

References 69 publications

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“…For primary localized GISTs, the first-line adjuvant treatment is imatinib, a tyrosine kinase inhibitor [ 28 ]. Other retrospective and prospective trials have confirmed that imatinib can minimize tumor recurrence [ 29 ]. Unfortunately, confirmation of the final timing of the use of an adjuvant therapy with imatinib is pending the results of ongoing controlled studies [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Nomogram for Predicting Recurrence-Free Survival of Primary Localized Gastrointestinal Stromal Tumor

Ran

Tan

Zhou

et al. 2023

JPM

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Purpose: This study aimed to establish a new nomogram that predicts recurrence-free survival (RFS) after a complete surgical resection of primary localized gastrointestinal stromal tumors (GISTs); it also aimed to evaluate the discrimination, calibration, and clinical utility of the decision-making nomogram. Methods: The clinicopathological data of patients with primary localized GISTs at the First Affiliated Hospital of Chongqing Medical University from January 2000 to June 2022 were retrospectively analyzed. The clinicopathological data were randomly split into two sets (7:3 ratio) for training and validation. Suitable variables for the construction of a nomogram for the 1-, 3-, and 5-year RFS were selected using univariate and multivariate Cox regression analyses. Receiver operating characteristic (ROC) analysis and a concordance index (C-index) were used to quantify the discrimination of the nomogram and were compared with four commonly used prognostic scoring systems: Memorial Sloan Kettering Cancer Center prognostic nomogram, National Institutes of Health–Fletcher staging system, Chen’s prognostic nomogram, and Air Forces Institute of Pathology risk criteria–Miettinen staging system. The calibration and clinical utility for the decision-making nomogram were validated using calibration curves and decision curves, respectively. Results: In total, 641 patients were screened and analyzed in this retrospective, observational study. RFS was significantly related to tumor size, mitotic count, gender, DOG-1, and adjuvant therapy with imatinib according to the results of the multivariate and univariate Cox analyses. The nomogram was constructed using the above variables (all p < 0.05) for the 1-, 3-, and 5-year RFS. In the training set, the 1-, 3-, and 5-year ROC and C-index values of the nomogram were 0.868, 0.838, 0.816, and 0.830, respectively. For internal validation, we performed model fitting on the validation set, and the 1-, 3-, and 5-year ROC and C-indices were 0.977, 0.845, 0.869, and 0.849, respectively. Among the five GIST prognostic scoring systems, our nomogram had almost all the largest area under these decision curves and had a good calibration capability. Conclusions: The newly constructed nomogram based on tumor size, gender, mitotic count, DOG-1, and adjuvant treatment with imatinib exhibited an excellent performance and may serve as a prognostic scoring system to support therapeutic decision-making and individualized treatment for GISTs in China.

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Section: Discussionmentioning

confidence: 99%

Nomogram for Predicting Recurrence-Free Survival of Primary Localized Gastrointestinal Stromal Tumor

Ran

Tan

Zhou

et al. 2023

JPM

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“…Even though GISTs are located in the stomach with size less than 2 cm, attention should be paid on the risk under EUS or pathology for further determination of the implementation of operation. Higher risk tends to include irregular and unclear border, echogenic foci, high mitotic rate, cystic degeneration, strong echo, ulcer, hemorrhage, and heterogeneity ( 21 , 28 , 29 ). Without the presentation of these manifestations, regular follow-up surveillance is recommended.…”

Section: Surgical Management In Gastrointestinal Stromal Tumorsmentioning

confidence: 99%

“…Simultaneously, genotyping tests prior to TKI therapy are essential for the identification of types of targeted drugs, and vigilant focus should be paid on imatinib-insensitive tumors such as PDGFRA D842 V mutations ( 46 ). Prior to the operation, neoadjuvant therapy should be conducted for 6–12 months so as to realize maximal chemotherapy outcome ( 29 , 35 ). With respect to the embarking moment of surgery, the ESMO–EURACAN guidelines recommend to stop neoadjuvant therapy just before surgery and resume immediately after patients’ postoperative recovery ( 23 ).…”

Section: Surgical Management In Gastrointestinal Stromal Tumorsmentioning

confidence: 99%

Advances of endoscopic and surgical management in gastrointestinal stromal tumors

2023

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As one of the most common mesenchymal malignancies in the digestive system, gastrointestinal stromal tumors (GISTs) occur throughout the alimentary tract with diversified oncological characteristics. With the advent of the tyrosine kinase inhibitor era, the treatment regimens of patients with GISTs have been revolutionized and GISTs have become the paradigm of multidisciplinary therapy. However, surgery resection remains recognized as the potentially curative management for the radical resection and provided with favorable oncological outcomes. The existing available surgery algorithms in clinical practice primarily incorporate open procedure, and endoscopic and laparoscopic surgery together with combined operation techniques. The performance of various surgery methods often refers to the consideration of risk evaluation of recurrence and metastases; the degree of disease progression; size, location, and growth pattern of tumor; general conditions of selected patients; and indications and safety profile of various techniques. In the present review, we summarize the fundamental principle of surgery of GISTs based on risk assessment as well as tumor size, location, and degree of progress with an emphasis on the indications, strengths, and limitations of current surgery techniques.

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Pan-Canadian consensus recommendations for GIST management in high- and low-throughput centres across Canada

Beecroft,

Brar,

Feng

et al. 2024

Ther Adv Med Oncol

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Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours that originate from the interstitial cells of Cajal. GISTs are mainly driven by gain-of-function mutations in receptor tyrosine kinase or platelet-derived growth factor receptor alpha. Surgical resection is the only curative treatment for localized tumours and all currently approved medical GIST treatments are based on orally available tyrosine kinase inhibitors. Recent discoveries in the molecular and clinical features of GISTs have greatly impacted GIST management. Due to the provincially rather than nationally administered Canadian healthcare system, there have been inconsistencies in the treatment of GISTs across the country. Therefore, guidance on the latest knowledge, clinical management and treatment of GIST is needed to standardize the approach to GIST management nationwide. To establish pan-Canadian guidance, provide up-to-date data and harmonize the clinical practice of GIST management in high- and low-throughput centres across Canada; a panel of 20 physicians with extensive clinical experience in GIST management reviewed relevant literature. This included radiologists, pathologists, interventional radiologists, surgeons and medical oncologists across Canada. The structured literature focused on seven key domains: molecular profiling, radiological techniques/reporting, targeted localized therapy, intricacies of systemic treatments, emerging tests, multidisciplinary care and patient advocacy. This literature review, along with clinical expertise and opinion, was used to develop this concise and clinically relevant consensus paper to harmonize the knowledge and clinical practice on GIST management across Canada. The content presented here will help guide healthcare providers, especially in Canada, in terms of approaching and managing GIST.

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Gastrointestinal Stromal Tumor

Cited by 9 publications

References 69 publications

Nomogram for Predicting Recurrence-Free Survival of Primary Localized Gastrointestinal Stromal Tumor

Nomogram for Predicting Recurrence-Free Survival of Primary Localized Gastrointestinal Stromal Tumor

Advances of endoscopic and surgical management in gastrointestinal stromal tumors

Pan-Canadian consensus recommendations for GIST management in high- and low-throughput centres across Canada

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