Gastrointestinal stromal tumours
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288 Hellenic Journal of Surgery 2012; 84: 5
Gastrointestinal Stromal Tumours A Case Series of Eight Patients and a Short Review N. Krokos, E. Michailidou, A. Karakatsanis, A. Margioulas, P. Sarafianos Received 22/03/2012 Accepted 24/07/2012
Abstract Aim-Background: 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 mitoses. Methods: A series of 8 cases of patients with GISTs that were treated in our department is presented in this article, as well as a brief review of the relevant literature. Results: None 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 follow-up, except for one patient who passed away due a myocardial infarction. Conclusion: GISTs 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.
Key words:
Gastrointestinal stromal tumours (GISTs), Management, Therapy, review
Introduction Stromal tumours are the most common mesenchymal tumour of the intestinal tract, notwithstanding the fact that they represent 0.1-3% of gastrointestinal malignancies. These infrequent tumours have unique characteristics that allow their distinction from other mesenchymal tumours, such as leiomyomas and leiosarcomas, as well as the exploitation of a potent kinase inhibitor, imatinib.
Case Series Report The corresponding author takes responsibility for the integrity and accuracy of data analysis. Table 1 Location on GIS tumours PATIENTS
N. Krokos (Corresponding author), - Consultant of Ge
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