Endoscopic resection of gastric gastrointestinal stromal tumors

Aims. To review the clinical presentation, diagnosis, assessment of risk of malignancy, and recent advances in management (mainly focusing on the role of endoscopic resection) of gastrointestinal stromal tumors (GISTs) in upper GI.Method. We searched Embase, Web of science, and PubMed databases from 1993 to 2018 by using the following keywords: “gastrointestinal stromal tumors,” “GIST,” “treatment,” and “diagnosis.” Additional papers were searched manually from references of the related articles.Findings. The improvement of endoscopic techniques in treating upper gastrointestinal subepithelial tumors especially gastrointestinal tumors has reduced the need for invasive surgery in patients unfit for surgery. Many studies have concluded that modified endoscopic treatments are effective and safe. These treatments permit minimal tissue resection, better dissection control, and high rates of en bloc resection with an acceptable rate of complications.

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Submucosal Tunneling Endoscopic Resection for En Bloc Removal of Large Esophageal Gastrointestinal Stromal Tumors

Gastroenterology ◽

10.1053/j.gastro.2016.11.044 ◽

2017 ◽

Vol 152 (3) ◽

pp. 482-483 ◽

Cited By ~ 4

Author(s):

Nikhil A. Kumta ◽

Monica Saumoy ◽

Amy Tyberg ◽

Michel Kahaleh

Keyword(s):

Endoscopic Resection ◽

Gastrointestinal Stromal Tumors ◽

En Bloc ◽

Submucosal Tunneling Endoscopic Resection ◽

Stromal Tumors

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W1723 Long-Term Follow-up of Patients With Gastric Gastrointestinal Stromal Tumors (GISTs) 5 CM or Less After Surgical or Endoscopic Resection

Gastroenterology ◽

10.1016/s0016-5085(10)63343-4 ◽

2010 ◽

Vol 138 (5) ◽

pp. S-727

Author(s):

Mi-Young Kim ◽

Kee Don Choi ◽

Jeong Hoon Lee ◽

Hye-won Park ◽

Do Hoon Kim ◽

...

Keyword(s):

Endoscopic Resection ◽

Gastrointestinal Stromal Tumors ◽

Stromal Tumors ◽

Long Term Follow Up

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Sa1571 Preliminary Evaluation of Submucosal Tunneling Endoscopic Resection for the Treatment of Gastrointestinal Stromal Tumors of the Stomach

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2014.05.189 ◽

2014 ◽

Vol 79 (5) ◽

pp. AB259

Author(s):

Jian-Wei Hu ◽

Mei-Dong Xu ◽

Ping-Hong Zhou ◽

LI-Qing Yao

Keyword(s):

Endoscopic Resection ◽

Gastrointestinal Stromal Tumors ◽

Preliminary Evaluation ◽

Submucosal Tunneling Endoscopic Resection ◽

Stromal Tumors

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

Endoscopy International Open ◽

10.1055/a-0619-4803 ◽

2018 ◽

Vol 06 (08) ◽

pp. E950-E956 ◽

Cited By ~ 1

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.

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