Multivisceral resections of gastrointestinal stromal tumors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20523-20523
Author(s):  
Y. Zhou ◽  
C. Du ◽  
H. Fu ◽  
G. Zhao ◽  
Y. Shi
Keyword(s):  
Lymph Node ◽  
Imatinib Mesylate ◽  
Gastrointestinal Stromal Tumors ◽  
Abdominal Cavity ◽  
Tumor Diameter ◽  
Gross Margin ◽  
En Bloc ◽  
Primary Tumors ◽  
Stromal Tumors

20523 Background: Gastrointestinal stromal tumors (GISTs) with positive kit staining, although rare, are the most common mesenchymal neoplasms affecting the gastrointestinal tract. We present our experience in the treatment of disease involving adjacent organs with multivisceral resections. Methods: The clinicopathologic records of twenty-two patients with multivisceral resection, among 170 patients suffered from GISTs treated in our hospital from 1994 to 2005, were retrospectively reviewed. Nine primary tumors originated from the stomach, 4 from the small intestine, 6 from the colorectum, 1 from abdominal cavity, and 2 from the retroperitoneal area. Meanwhile complete follow-up records were available in 15 patients with median 5-year follow-up. Results: The patients included 9 men and 13 women, from 36 to 77 year old. The largest tumor diameter ranged from 2 to 20 cm. The types of multivisceral operation comprised splenectomy (n=8), coloectomy (n=6), nephrectomy (n=5), partial hepatectomy (n=1), duodenectomy (n=1), oophorectomy (n=1), pancreatectomy (n=1), and adrenalectomy (n=1). None of lymph node metastatsis was found in 7 patients with lymph node dissection with gastric GISTs (n=5) or small intestinal GISTs (n=2). The involved organs confirmed by the pathologic diagnosis included kidney (n=2), spleen (n=2), pancreas (n=2), mesentery (n=1), and omentum (n=1). There was no perioperative mortality in this series. Among follow up patients, 9 were alive and 5 were died from the tumor recurrence or metastasis. Among them, one person with gastrectomy, pancreatectomy, adrenalectomy is still alive under 2 year follow-up by imatinib mesylate therapy postoperatively. Conclusions: Complete surgical resection with a negative gross margin by en bloc resection of the involved organs remains the standard treatment for non-metastatic GISTs. Imatinib mesylate represents a major breakthrough in the treatment of advanced GISTs and is the first effective systemic therapy for the disease. No significant financial relationships to disclose.

Imatinib mesylate therapy in advanced gastrointestinal stromal tumors—A Regional cancer centre experience

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 19505-19505
Author(s):  
K. M. Patel ◽  
P. M. Shah ◽  
S. N. Shukla ◽  
B. J. Parikh ◽  
A. S. Anand ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Imatinib Mesylate ◽  
Metastatic Disease ◽  
Gastrointestinal Stromal Tumors ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Free Survival ◽  
Stromal Tumors ◽  
Post Surgery

19505 Background: The treatment of gastrointestinal stromal tumors has been revolutionised by the advent of Imatinib, a specific tyrosine kinase inhibitor. Post operative local and metastatic recurrences of this tumor have been effectively managed by Imatinib. Here we present our experience of Imatinib in recurrent locally advanced/metastatic gastrointestinal stromal tumors (GIST). Methods: From Nov 2001 to Sep 2005, 33 patients with metastatic and / or locally advanced inoperable CD-117 positive GIST were offered imatinib mesylate therapy at 400 mg/day p.o. A total of 21 patients were evaluable for tumor response. Follow up period ranged from 4 months to 38 months with median follow up period being 18 months. Median age is 58 yrs, M:F ratio is 6:4. ECOG performance status was 0–1 in 70% (23 patients) and 2 in 30% (10 patients). 70% patients had post surgery recurrence. 2 patients (6%) had received adjuvant chemotherapy prior to recurrence. 30% (10 patients) had local recurrence, 40% (13 patients) had metastatic disease while 30% (10 patients) had local recurrence as well as metastatic disease. Results: Response evaluation was done by RECIST criteria. 15% (5 patient) showed CR while PR rates were 30% (10 patients). The overall major response (CR+PR) was 45%. The overall progression free survival was as high as 80%. All the patients who had a progression free survival also had a significant improvement in quality of life. Conclusions: Imatinib mesylate therapy shows significant survival benefits in locally advanced inoperable/metatstatic gastrointestinal stromal tumors. It will be a very long time before PET scan for evaluation and follow up becomes feasible in developing country setting. No significant financial relationships to disclose.

scholarly journals Tumor rupture of gastric gastrointestinal stromal tumors during endoscopic resection: a risk factor for peritoneal metastasis?

2018 ◽  
Vol 06 (08) ◽  
pp. E950-E956 ◽  
Author(s):  
Shiyi Song ◽  
Wei Ren ◽  
Yi Wang ◽  
Shu Zhang ◽  
Song Zhang ◽  
...  
Keyword(s):  
Risk Factor ◽  
Endoscopic Resection ◽  
Peritoneal Metastasis ◽  
Gastrointestinal Stromal Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Tumor Rupture ◽  
En Bloc ◽  
Stromal Tumors

Abstract Background and study aims Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract. Up to the present time, complete surgical excision has been the standard treatment for primary GISTs greater than 2 cm. It is well known that tumor rupture during surgery is an independent risk factor for peritoneal metastasis; however, it is not known whether the risk of peritoneal metastasis increases in cases where the tumor is ruptured during endoscopic resection. Patients and methods A total of 195 patients treated for GIST between January 2014 and December 2016 in our hospital were enrolled in this study. They were divided into two groups according to whether the tumor was ruptured during endoscopic resection. The rate of peritoneal metastasis in patients in the two groups who also suffered perforation was investigated from the follow-up results. Results Approximately 55.4 % of all patients were female and the average age of the study group was 59.0 ± 10.3 years. Of the 195 patients, the tumors in 27 were ruptured and the remaining 168 patients underwent en bloc resection. There was no statistically significant difference in gender or age between the two groups. The median tumor size (maximum diameter) in all patients was 1.5 cm (0.3 – 5.0 cm): 2.5 cm (0.8 – 5.0 cm) and 1.4 cm (0.3 – 4.0 cm) in the tumor rupture group and en bloc resection group, respectively (P < 0.001). Most of the tumors were located in the gastric fundus. At a median follow-up of 18.7 ± 10.2 months, neither tumor recurrence (liver metastasis, peritoneal metastasis, local recurrence) nor mortality related to GISTs were detected. Conclusions Tumor rupture during endoscopic resection of gastric GISTs may not be a risk factor for peritoneal metastasis.

Gastrointestinal Stromal Tumors: A Single Institution Experience of 176 Surgical Patients

2013 ◽  
Vol 79 (7) ◽  
pp. 657-665 ◽  
Author(s):  
Sarah B. Fisher ◽  
Steven C. Kim ◽  
David A. Kooby ◽  
Kenneth Cardona ◽  
Maria C. Russell ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Laparoscopic Resection ◽  
Positive Margin ◽  
Single Institution ◽  
Clinicopathologic Characteristics ◽  
Primary Tumors ◽  
Stromal Tumors ◽  
Primary Gist ◽  
Metastatic Gist

Large single-institution series of patients undergoing resection for gastrointestinal stromal tumors (GIST) are lacking. Clinicopathologic characteristics and postoperative outcomes were retrospectively collected and analyzed from patients undergoing resection for GIST from 2002 to 2011. One hundred seventy-six patients were identified; 156 underwent resection of primary nonmetastatic disease. KIT mutations were identified in 131 patients (84.0%). Of the 156 patients with primary disease, the most common site was the stomach (75.6%). Tumors were categorized as very low (24.4%), low (35.9%), intermediate (12.2%), high (24.4%), or unknown (3.2%) risk. Symptomatic patients more often had high risk (35.6 vs 9.8%; P < 0.0001) and larger tumors (7.3 vs 3.0 cm; P < 0.0001). Forty-seven patients (30.1%) underwent laparoscopic resection (LR). Compared with open surgery, LR was performed for smaller tumors (3.8 vs 6.2 cm; P = 0.002). Positive margin rates were similar (4.3% LR vs 10.2% open; P = 0.346). Median follow-up for the 156 patients with primary tumors was 32.9 months; mean overall survival was 120.9 months (median not reached). Of the 20 patients with metastatic GIST (excluded from above analysis), five patients (25.0%) died of disease with a median follow-up of 15.9 months. Most patients with resectable primary GIST have a favorable prognosis. The presence of symptoms directly related to GIST may be associated with a poor prognosis and is likely related to increased tumor size. Laparoscopic resection is well tolerated and does not appear to compromise outcomes in well-selected patients. Highly selected patients with metastatic disease may benefit from resection.

scholarly journals Virškinimo trakto stromos navikų chirurginio gydymo principai

2006 ◽  
Vol 4 (2) ◽  
pp. 0-0
Author(s):  
Raimundas Lunevičius ◽  
Michitaka Fujiwara ◽  
Juozas Stanaitis
Keyword(s):  
Imatinib Mesylate ◽  
Surgical Resection ◽  
Gastrointestinal Stromal Tumors ◽  
Indications For Surgery ◽  
Stromal Tumors ◽  
Regional Lymphadenectomy ◽  
Active Research ◽  
Vilnius University ◽  
Key Words Gastrointestinal

Raimundas Lunevičius1, Michitaka Fujiwara2, Juozas Stanaitis11 Vilniaus universiteto Bendrosios ir plastinės chirurgijosortopedijos ir traumatologijos klinika,Šiltnamių g. 29, LT-041302 Nagojos universitetas, 2-asis chirurgijos skyrius, Endoskopinės chirurgijos centras,65 Tsurumai-cho, Showa-ku, Nagoya 466, JaponijaEl. paštas: [email protected] Įvadas / tikslas Chirurginis gydymas yra pagrindinis siekiant išgydyti virškinimo trakto stromos navikais sergančius ligonius. Straipsnio tikslas – apibūdinti šios ligos chirurginio gydymo indikacijas, principus ir vėlyvus rezultatus. Apžvalga Kertiniai klausimai, į kuriuos turi atsakyti klinicistas siekdamas nustatyti GIST chirurginio gydymo indikacijas, yra tokie: (i) ar tai pirminis lokalus chirurgiškai radikaliai pašalinamas GIST; jei taip – tai yra indikacija operuoti visais atvejais; (ii) ar tai yra lokaliai ar atokiai išplitęs GIST (kai naviko radikalaus pašalinimo galimybės yra labai ribotos arba jų nėra); jei taip – tai yra indikacija skirti neoadjuvantinę terapiją imatinibo mezilatu. Tokiu atveju chirurginio gydymo galimybės iš naujo vertinamos praėjus 3, 6, 9 mėn. ir daugiau nuo nepertraukiamo gydymo vaistais pradžios. Tai lemia naviko atsakas į gydymą vaistais. Virškinimo trakto stromos naviko operacijos tikslas – visiškas naviko pašalinimas apimant nepažeistus audinius. Atstumas nuo naviko kraštų turi būti ne mažesnis kaip 1–2 cm. Sisteminė sritinė limfadenektomija nedaroma arba daroma labai retai, tai yra tais atvejais, kai yra metastazių sritiniuose limfmazgiuose. Nustačius recidyvinį ar metastazavusį virškinimo trakto stromos naviką, klinicistui keliami tokie uždaviniai: pirma, išsiaiškinti chirurginės rezekcijos galimybes; antra, pagrįsti imatinibo mezilato skyrimo būtinumą. GIST dvinaris skirstymas į mažo piktybiškumo ir didelio piktybiškumo navikus klinicistui yra priimtinas. Išvada Siekiant pagerinti GIST gydymo rezultatus, būtini tolesni aktyvūs GIST diagnostikos ir gydymo tyrimai. Reikšminiai žodžiai: virškinimo trakto stromos navikai (GIST), chirurginis gydymas, imatinibo mezilatas Principles of surgical treatment of gastrointestinal stromal tumors Raimundas Lunevičius1, Michitaka Fujiwara2, Juozas Stanaitis11 Vilnius University, Clinic of General and Plastic Surgery, Orthopedics and Trauma SurgeryŠiltnamių str. 29 LT-04130 Vilnius, Lithuania2 Nagoya University, 2nd Department of Surgery, Section of Endoscopic Surgery,65 Tsurumai-cho, Showa-ku, Nagoya 466, JapanE-mails: [email protected] Background / objective Surgical resection is the main choice of reliable recovery for GIST patients. The purpose of the article is as follows: to define indications for surgery, the principles of operations due to GIST, and late follow-up results. Review Most important points in defining indications for surgery are the following: (i) is it a primary localized resectable GIST? If yes, it is an absolute indication for surgery; (ii) is it a locally or distantly outspread GIST when the possibilities of surgical resection are very restricted or there are no them; if yes, it is an indication for neoadjuvant imatinib mesylate therapy. There is a need for re-consideration of indications for surgery after 3, 6, 9 and more months after permanent neoadjuvant therapy, depending on response of the tumor to medication. An operation should be aimed to performe complete en block removal of the tumor and the surrounding 1–2 cm length of tissue. A systematic regional lymphadenectomy is not recommended routinely. It is warranted only for evident regional nodal involvement. In case of a recurrent or metastatic disease, there is a necessity to determine the following: first, are threre still any possibilities for surgical resection; second, to motivate the necessity for imatinib mesylate therapy. Binary categorization of GIST into low and high malignant potential tumors is acceptable to clinicians. Conclusion To optimize results of GIST management, a further active research and consensus are needed. Key words: gastrointestinal stromal tumors (GIST), surgery, imatinib mesylate

Long-Term Follow-Up Outcome of Imatinib Mesylate Treatment for Recurrent and Unresectable Gastrointestinal Stromal Tumors

Digestion ◽  
2013 ◽  
Vol 87 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Seiko Saito ◽  
Katsunori Nakata ◽  
Shinya Kajiura ◽  
Takamaso Ando ◽  
Ayumu Hosokawa ◽  
...  
Keyword(s):  
Imatinib Mesylate ◽  
Gastrointestinal Stromal Tumors ◽  
Stromal Tumors ◽  
Long Term Follow Up

scholarly journals Second Primary Tumors in Patients with Gastrointestinal Stromal Tumors: A Single-Center Experience

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 494
Author(s):  
Murat Koçer ◽  
Sadık Muallaoğlu ◽  
Bülent Çetin ◽  
Hasan Şenol Coşkun ◽  
Nermin Karahan ◽  
...  
Keyword(s):  
Survival Data ◽  
Gastrointestinal Stromal Tumors ◽  
Low Risk ◽  
Gastrointestinal System ◽  
Second Primary ◽  
Single Center ◽  
Primary Tumors ◽  
Stromal Tumors ◽  
The Mean

Background and Objectives: In this study, we investigated the frequency and type of second primary malignant tumors (SPMTs) accompanying gastrointestinal stromal tumors (GISTs), patient and tumor characteristics, and follow-up and survival data. Materials and Methods: We included 20 patients with SPMTs from a total of 103 patients with GISTs in a single center in Turkey. At the time of GIST diagnosis, patient age, sex, presentation symptoms, localization, pathological features of the tumor, stage, recurrence risk scoring for localized disease, treatments received, time of SPMT association, follow-up times, and survival analysis were recorded for each patient. Localization, histopathology, and stage of SPMT accompanying GISTs were also recorded accordingly. Results: SPMT was detected in 19.4% of patients with GISTs. Of the patients, 50% were men and 50% were women. The mean age at the time of diagnosis of GIST was 63.8 ± 10.81 years (range: 39–77 years). Of the GISTs, 60% were localized in the stomach, 25% in the small intestine, and 70% were at low risk. Of the SPMTs, 60% were in the gastrointestinal system. SPMTs were diagnosed as synchronous with GISTs in 50% of the patients. The mean follow-up period of the patients from the diagnosis of GIST was 45.6 (0.43–129.6) months. When the data were finalized, 5% died due to GIST, 35% died due to SPMT, and 15% died due to non-disease-related causes. Conclusions: SPMT was detected in 19.4% of patients with GISTs. GISTs were frequently located in the stomach, and most of them were at low risk. The most common SPMTs were gastrointestinal system tumors, and their coexistence was found to be synchronous. Most patients died due to SPMT during follow-up.

Multislice imaging of gastrointestinal stromal tumors

2018 ◽  
pp. 3-14
Keyword(s):  
Computed Tomography ◽  
Key Words ◽  
Gold Standard ◽  
Gastrointestinal Stromal Tumors ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Preferential Localization ◽  
Multislice Imaging ◽  
Computed Tomography Diagnosis

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract (1%). These tumors express the CD 117 in 95% of cases. The stomach is the preferential localization (70%). Diagnosis is difficult and sometimes late. Progress of imaging has greatly improved the management and the prognosis. Computed tomography (CT) is the gold standard for diagnosis, staging, and treatment follow-up. The increasing recognition of GIST’s histopathology and the prolonged survival revealed some suggestive imaging aspects. Key words: gastro-intestinal stromal tumors; computed tomography; diagnosis

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