Surgical management of gastrointestinal stromal tumours

Gervaz, Pascal; Huber, Olivier; Morel, Philippe

doi:10.1002/bjs.6601

Cited by 100 publications

(104 citation statements)

References 97 publications

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“…Our data showed that small GISTs located within 5 cm of the anal verge are ideally treated with trans-anal local resection. Limited resection is theoretically simple and feasible, but the risk of early tumor recurrence caused by incomplete excision has been noted in a previous study [18]. We observed that 47.6% of the total number of patients experienced tumor recurrence or metastasis after local resection, and this rate was higher than that of the abdominoperineal resection (38.5%) and the super-low or low anterior resection (27.3%).…”

Section: Discussionmentioning

confidence: 55%

Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Shen¹,

CHEN²,

Yin³

et al. 2015

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Rectal gastrointestinal stromal tumors (GISTs) are rare, and limited information is available concerning their management and long-term outcomes. We retrospectively evaluated the clinicopathological characteristics, surgical management, and long-term outcomes of rectal GISTs from a single institution.All surgically treated patients with rectal GISTS at the Department of General Surgery, West China Hospital, Sichuan University were identified between January 2005 and May 2014. The overall survival (OS) and disease-free survival (DFS) were assessed by the Kaplan-Meier method.Forty-five patients with rectal GISTs (33 males and 12 females) were identified. Patients presented with rectal bleeding (n = 13; 28.9%) and altered bowel habits (n = 11; 24.4%). The cohort study of 45 patients included 4 very low-risk, 10 lowrisk, 1 intermediate-risk, and 30 high-risk patients. A total of 21, 13, and 11 patients underwent local resection (Group 1), abdominoperineal resection (Group 2), and super-low or low anterior resection (Group 3), respectively. Group 1 had a smaller tumor sizes and shorter distances from the anal verge compared with the other groups (P < 0.05). The one-, three-, and fiveyear DFS rates for the entire cohort study were 90.4%, 69.3%, and 57.0%, respectively. High National Institutes of Health (NIH) risk categories (HR = 1.62) were associated with low DFS rates (P = 0.035). The DFS was significantly improved by imatinib mesylate (IM) adjuvant therapy in the high-risk subgroup (P = 0.001).The type of surgery should be chosen based on the location and size of the rectal GISTs. Adjuvant IM therapy was associated with improved DFS in patients with high-risk tumors, and classification was strongly associated with the patient outcome.

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Section: Discussionmentioning

confidence: 55%

Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Shen¹,

CHEN²,

Yin³

et al. 2015

neo

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“…предполагается, что GIST происходят из предшественников интерстициальных кле-ток Cajal [2,3,8,10]. при иммуногистохимиче-ском исследовании характерна положительная реакция с антителами к CD117 (>95% случаев), CD34 (60-70%) и c-kit белками (70-85%) [2,3,8,10,11,13,14,15,16]. опухоль характери-зуется наличием капсулы, локальным распро-странением с преимущественным отсутствием тенденции к поражению регионарных лим-фатических узлов и метастазированию [2,17].…”

Section: Discussionunclassified

Gastrointestinal stromal tumor of the duodenum

Shturich¹,

Ермашкевич²

2013

Novosti Khirurgii

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“…The most typical feature of a duodenal GIST is the formation of a deep ulceration in the mucosa or an intramural mass with a centrally ulcerated umbilication (7). Therefore, bleeding is the most common symptom at presentation.…”

Section: Discussionmentioning

confidence: 99%

Small duodenal gastrointestinal stromal tumor presenting with acute bleeding misdiagnosed as hemobilia: Two case reports

et al. 2012

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Abstract. Only 3-5% of gastrointestinal stromal tumors (GISTs) are located in the duodenum. They are associated with an increased risk of fatal gastrointestinal bleeding, which is a primary manifestation. A small GIST (less than 2 cm in size) is easily confused with a duodenal papilla. In the 2 cases presented in this study, endoscopic examination alone resulted in a misdiagnoses of hemobilia. To the best of our knowledge, this is the first case report of this type in the literature. Patient 1 is a 66-year-old male who was admitted to The Second Affiliated Hospital of Dalian Medical University with syncope. Emergent upper gastrointestinal endoscopy identified bleeding from what appeared to be a duodenal papilla, and the patient was diagnosed with hemobilia. However, the angiography did not support this result. To save the patient's life, an exploratory laparotomy was conducted. We identified a small tumor in the descending part of the duodenum and a wedge resection was successfully conducted. The final diagnosis was duodenal GIST with no further risk to the patient. Patient 2 is a 71-year-old female who was admitted to the hospital diagnosed with hemobilia. The patient underwent a barium swallow examination and a contrast-enhanced computed tomography (CT) scan, in which a tumor on the descending part of the duodenum was identified. Patient 2 also underwent a wedge resection. The final diagnosis was duodenal GIST with no further risk to the patient. Gastroscopy may be a useful procedure for duodenal GIST diagnosis; however, the endoscopic findings may be confused with hemobilia when the tumor diameter is less than 2 cm in size and heavily accompanied with blood clots. A barium swallow examination and contrast-enhanced CT may prevent a misdiagnosis of hemobilia.

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Surgical management of gastrointestinal stromal tumours

Cited by 100 publications

References 97 publications

Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Gastrointestinal stromal tumor of the duodenum

Small duodenal gastrointestinal stromal tumor presenting with acute bleeding misdiagnosed as hemobilia: Two case reports

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