Tumores del estroma gastrointestinal (GIST): factores pronósticos de supervivencia tras citorreducción R0

Hidalgo, José Manuel; Casares, Francisco; Peña, Sebastián Rufían; Torres, A. Naranjo; Bru, Rubén Ciria; Delgado, Javier Briceño; Cillero, Pedro López

doi:10.4321/s1130-01082007001200005

Cited by 7 publications

(2 citation statements)

References 25 publications

(23 reference statements)

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“…It is necessary to determine mitotic rate, grade of dedifferentiation, size, location, tumor infiltration, grade of necrosis and hemorrhage, surgical margins, and whether a tumor ruptures because these factors are implicated in the risk of relapse[ 117 ]. Ki67 is an important prognostic factor that has been implicated in recurrence and survival and should be included in pathologist’s report[ 118 , 119 ] (See Table 3 ). The depth of tumor infiltration, including serosal penetration has been proposed as a prognostic factor for patients with GISTs with significantly poorer prognosis compared to its absence[ 120 , 121 ].…”

Section: Role Of Pathologistmentioning

confidence: 99%

Gastrointestinal stromal tumors: A multidisciplinary challenge

Sánchez-Hidalgo¹,

Durán²,

Molero-Payan³

et al. 2018

WJG

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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment. The arise of tyrosine kinase inhibitor has supposed a revolution in GISTs treatment being useful as adjuvant, neoadjuvant or recurrence disease treatment. That is why a multidisciplinary approach to this disease is required. The correct characterization of the tumor at diagnosis (the diagnosis of recurrences and the evaluation of the response to treatment with tyrosine kinase inhibitors) is fundamental for facing these tumors and requires specialized Endoscopist, Radiologists and Nuclear Medicine Physician. Surgery is the only potentially curative treatment for suspected resectable GIST. In the case of high risk GISTs, surgery plus adjuvant Imatinib-Mesylate for 3 years is the standard treatment. Neoadjuvant imatinib-mesylate should be considered to shrink the tumor in case of locally advanced primary or recurrence disease, unresectable or potentially resectable metastasic tumors, and potentially resectable disease in complex anatomic locations to decrease the related morbidity. In the case of Metastatic GIST under Neoadjuvant treatment, when there are complete response, stable disease or limited disease progression, complete cytoreductive surgery could be a therapeutic option if feasible.

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Section: Role Of Pathologistmentioning

confidence: 99%

Gastrointestinal stromal tumors: A multidisciplinary challenge

Sánchez-Hidalgo¹,

Durán²,

Molero-Payan³

et al. 2018

WJG

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“…El tratamiento de los GIST será quirúrgico, realizando resección radical de la tumoración (R0), incluyendo lesiones metastásicas resecables y reacción en bloque de órga-nos afectados (13)(14)(15). La utilización en situaciones de irresecabilidad o enfermedad a distancia de inhibidores de proteína quinasas como el mesilato de imatinib, ha mostrado resultados esperanzadores.…”

Section: Discussionunclassified

Determinación inmunohistoquímica y utilidad pronóstica del receptor del factor de crecimiento epidérmico en los tumores estromales gastrointestinales

Padilla

Menéndez

Garcı́a

et al. 2008

Rev. esp. enferm. dig.

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Gastrointestinal Stromal Tumors (GIST): A Prospective Evaluation of Risk Factors and Prognostic Scores

Sánchez-Hidalgo

Peña

Bru

et al. 2009

J Gastrointest Canc

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Thirteen patients suffered recurrences (27.7%). Eleven died from disease-related causes. Two-year and 5-year actuarial survival was 80% and 76%, respectively, and the mean survival was 60 months (CI 95% 51.9-69.5). Two-year and 5-year actuarial disease-free survival was 76% and 72% respectively, and the mean disease-free survival was 52 months (CI 95% 43.5-61.1). The score proposed by Fletcher has the greatest sensitivity and specificity in our series to predict overall survival (AUROC = 0.761; SE 0.084, p = 0.009; CI 95% 0.597-0.926) and recurrence (AUROC RECURRENCE = 0.693; SE 0.087, p = 0.042; CI 95% 0.523-0.864) compared with other scores.

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Tumores del estroma gastrointestinal (GIST): factores pronósticos de supervivencia tras citorreducción R0

Cited by 7 publications

References 25 publications

Gastrointestinal stromal tumors: A multidisciplinary challenge

Gastrointestinal stromal tumors: A multidisciplinary challenge

Determinación inmunohistoquímica y utilidad pronóstica del receptor del factor de crecimiento epidérmico en los tumores estromales gastrointestinales

Gastrointestinal Stromal Tumors (GIST): A Prospective Evaluation of Risk Factors and Prognostic Scores

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