Gastrointestinal stromal tumors (GIST) of the duodenum: A French Sarcoma Group (FSG) retrospective review of 90 patients (pts).

Duffaud, F.; Ray-Coquard, I. L.; Blesius, Aurore; Huynh, T. K.; Boucher, E.; Bouché, Olivier; Bay, Jacques Olivier; Marchal, Frédéric; Spano, Jean Philippe; Bertucci, François; Nguyen, Binh Bui; Collard, Olivier; Chaigneau, L.; Isambert, Nicolás; Adenis, Antoine; Mancini, Julien; Cesne, Axel Le; Blay, J-Y.

doi:10.1200/jco.2011.29.15_suppl.10053

Cited by 3 publications

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“…Our study focused on GISTs of the duodenum and proximal jejunum showed that the 3-year overall survival and progression free survival were both 86.1%. Our results were similar to a retrospective review report in the literature, which suggested that 4-year OS and EFS rate of localized duodenal GISTs were 89% and 58% respectively [3].…”

Section: Table 5asupporting

confidence: 91%

Resection of GIST in the duodenum and proximal jejunum: A retrospective analysis of outcomes

Huang

Chen

Lin

et al. 2019

European Journal of Surgical Oncology

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Introduction: Gastrointestinal stromal tumors (GISTs), with a primary occurrence in the duodenum and proximal jejunum, are rare and treatment is poorly understood. This study aimed to evaluate the main factors influencing the prognosis of GIST resection in this complex anatomical structure. Materials and methods: This retrospective study included 47 patients who underwent surgery for primary GIST of the duodenum (20) and proximal jejunum (27) between 2012 and 2017. Perioperative clinical data as well as relapse and survival information were collected. Results: All patients underwent negative margin resection (R0) of duodenal and proximal jejunum GISTs. Complications occurred more frequently in treatment of duodenal GISTs than proximal jejunum GISTs (p ¼ 0.003). GISTs in D3 (the 3rd portion of duodenum) were related to larger tumor size (p ¼ 0.001), higher probability of severe complication rate (p ¼ 0.042), longer hospital stays (p ¼ 0.023) and fasting time (p ¼ 0.020). More complications were found for patients with digestive reconstruction than limited resection (p ¼ 0.010). Additionally, patients with a tumor mass larger than 5 cm or a mitotic index greater than 5 mitoses/50 HPFs showed poorer therapeutic outcomes. The 1-and 3-year overall survival was 97.9% and 86.1%, respectively and were not influenced by operation type (p ¼ 0.061) or GIST position (p ¼ 0.447). Conclusion: With negative operational margins, limited resection is a safe and feasible procedure for duodenal and proximal jejunum GIST patients and unnecessary digestive reconstruction should be avoided. Considering the severe complication rate, resection for GISTs in D3 should be performed with care.

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Section: Table 5asupporting

confidence: 91%

Resection of GIST in the duodenum and proximal jejunum: A retrospective analysis of outcomes

Huang

Chen

Lin

et al. 2019

European Journal of Surgical Oncology

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“…This is why DGISTs have attracted the authors' interests as well as the attention of the French Sarcoma Group (GSF-GETO). In the 47 th Annual Meet-ing of the American Society of Clinical Oncology held in Chicago in June 2011, Duffaud et al [12] at GSF-GETO12 retrospectively analyzed 66 resectable DGIST patients with a median tumor size of 6 cm (1.5-31 cm), 29 of whom underwent WR, 23 SR, and 14 PD. During a median follow-up of 36 (1-168) mo, their 4-year OS and RFS rates were 89% and 58%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The optimal surgical approach (LR or PD) for DG-ISTs is controversial. Goh et al [10] suggested that LR is associated with a shorter operation time, a similar complication rate, and a comparable disease-specific survival; Duffaud et al [12] concluded that LR rather than PD should be pursued to preserve optimal pancreas function for a better quality of life. According to the relatively few patients with long-term follow-up in this report, the findings support the views above.…”

Section: Discussionmentioning

confidence: 99%

“…GIPAP has relatively strict eligibility criteria, and the annual Glivec ® cost is far beyond the economic realities in China, therefore only a few urban patients benefit from this donation program, let alone rural populations. Accordingly, neoadjuvant imatinib therapy is impractical in China, despite the fact that it is believed to allow LR in patients with locally advanced DGISTs [12] .…”

Section: Discussionmentioning

confidence: 99%

“…However, the optimal surgical approach (LR or PD) for DGISTs is largely unknown, as all the available evidence has been derived from small retrospective series [11] . In addition, scholars have gradually recognized the complexities of DGISTs, and these tumors have been classified separately from other small intestine GISTs into an independent category [12] . Also, a number of papers on DGISTs have been released [8][9][10][13][14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

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Gastrointestinal stromal tumors of the duodenum: Surgical management and survival results

Liang

Yu²,

Zhu³

et al. 2013

WJG

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Duodenal GIST: a single center experience

Beham

Schaefer

Cameron

et al. 2012

Int J Colorectal Dis

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PurposeThe duodenum as primary site for gastrointestinal stromal tumors (GISTs) is rare and mitotic rate, tumor size, type of mutation and number of chromosomal aberrations have prognostic implications.MethodsWe analyzed the outcome of 13 patients with duodenal GISTs who underwent surgical tumor resection. Either segmental duodenectomy or pylorus-preserving duodenopancreatectomy was performed. The tumors were histopathologically examined and the risk of progression was assessed based on tumor size and mitotic count. Additionally, mutation analysis of the KIT and PDGFRA receptor tyrosine kinase genes and comparative genomic hybridization (CGH) were performed in all cases.ResultsEight patients underwent segmental duodenectomy and five patients were treated with pylorus-preserving duodenopancreatectomy. None of the five GISTs with low or no risk for malignancy according to the Miettinen classification developed tumor progress. In contrast, five of eight cases (62.5%) with high-risk tumors revealed tumor progress, and four of these patients died (50%). The median overall survival for all patients was 66 months, and the median disease-free survival 41 months. The operative procedure and type of mutation did not correlate with long-term survival. CGH analysis displayed −15q in 12/13 tumors, and −1p in 11/13 cases as characteristic chromosomal aberrations for intestinal origin. Notably, −22q was present in three of four cases with tumor progress.ConclusionsBoth segmental duodenectomy and pylorus-preserving duodenopancreatectomy are appropriate options to treat duodenal GIST and should be implemented depending on resectability and the patient's performing state. The Miettinen classification and CGH findings correlate with the clinical course.

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Gastrointestinal stromal tumors (GIST) of the duodenum: A French Sarcoma Group (FSG) retrospective review of 90 patients (pts).

Cited by 3 publications

References 0 publications

Resection of GIST in the duodenum and proximal jejunum: A retrospective analysis of outcomes

Resection of GIST in the duodenum and proximal jejunum: A retrospective analysis of outcomes

Gastrointestinal stromal tumors of the duodenum: Surgical management and survival results

Duodenal GIST: a single center experience

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