Recent Advancements in the Treatment of Rectal Gastrointestinal Stromal Tumor: In Era of Imatinib

Abstract

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor of the gastrointestinal tract, with an annual incidence of 10–15 cases per million. However, rectal GIST has a low incidence, accounting for approximately 0.1% of all rectal tumors. The treatment of rectal GISTs is still controversial and the relative unified guidelines and consensus opinions are inadequate. Treatment is based primarily on the clinical experience of the physician. The widespread application of neoadjuvant imatinib therapy allows diversification of treatment, especially in the choice of surgical methods. Herein, we reviewed the most recent literature and summarized the new progress in rectal tumor treatment, with the aim of providing patients with more systematic and individualized therapeutic strategies.

Anal canal gastrointestinal stromal tumour (GIST)

“…Anorectal GISTs relate to a poor prognosis because of the particular localisation, the risk of tumour rupture, tumour size and number of mitosis 11. GISTs bigger than 5 cm with a high mitotic rate increase the risk of metastasis to the liver and peritoneum 4 19…”

A Case Report Anal Gastrointestinal Stromal Tumor Presenting with Obstipation

“…Complete resection, as the key procedure in the treatment of rectal GIST, can ensure total tumor resection and avoid tumor rupture. Low rectal GISTs are a particular challenge because radical resection is associated with significant morbidity, and when the sphincter or pelvic floor muscles become involved, abdominal perineal resection and permanent colostomy are both required 8 . However, controversy exists in regards to whether an abdominoperineal resection or conservative surgery would be the best surgical procedure for anal canal GISTs.…”

CT, MR, and CEUS imaging features of recurrent GIST of the pre-sacral space: A case report

“…The histologic diagnosis of GIST is performed with immunohistochemistry and electron microscopy, which are able to recognize the presence of straining for tyrosine kinase receptor KIT (CD 117), confirming the presence of the interstitial cells of Cajal [4] . Because of the strong association between GISTs and KIT or PDGFRA mutations, there is the possibility to treat these malignancies with biologic targeted therapy, for example, with imatinib mesylate (IM) [5] .…”

“…In the 1970s IM therapy was discovered, a selective inhibitor of transmembrane receptor KIT protein tyrosine kinases which inhibits the proliferation of GIST tumor cells that are stimulated by the activation of this receptor [5] .…”