Gastrointestinal stromal tumours

Authors: N Krokos E Michailidou A Karakatsanis A Margioulas P Sarafianos

Publish Date: 2013/02/07

Volume: 84, Issue: 5, Pages: 288-294

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Abstract

The aim of this study is to present our experience in surgery of GIS tumours Gastrointestinal stromal tumours GISTs represent a unique category of neoplasms in patients that exhibit long term survival Sixty percent of GISTs present in the stomach 30 in the small intestine 5 in the colon and rectum and 5 in the oesophagus Twenty five percent of the patients are diagnosed with metastases when being evaluated for the first time due to the silent course of the disease Computed tomography CT is the best imaging modality for tumours 5 cm while endoscopic ultrasound EUS is ideal for tumours 2 cm Recent research has also proved PET scan either alone or combined with CT as a useful adjunct to the diagnosis and planning of a therapeutic plan Fifty percent of the patients may be cured with R0 excision without the need for adjuvant therapy Neoadjuvant therapy with imatinib is frequently employed in metastasized large or relapsed tumours Imatinib is also employed as adjuvant therapy in tumours that exhibit specific characteristics concerning its size location and the number of mitosesNone of our patients presented with metastatic disease while R0 excision was possible in every one of them All tumours were positive for CD117 while 7 out of 8 patients presented with tumours positive for the expression of CD34 Adjuvant therapy was administered to 5 out of 8 patients 62 All the treated patients remain alive and under oncologic followup except for one patient who passed away due a myocardial infarctionGISTs are infrequent tumors that due to their unique characteristics deserve special consideration and attention Specific intraoperative details are important for the treatment of the patients and prognosis An individualized approach is recommended and a multidisciplinary team consisting of radiologists oncologists and surgeons should care for these patients

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