Clinicopathologic Characteristics and Optimal Surgical Treatment of Duodenal Gastrointestinal Stromal Tumor

Lee, Seung-Jae; Song, Ki Byung; Lee, Young‐Joo; Kim, Song Cheol; Hwang, Dae Wook; Lee, Jae Hoon; Shin, Sang Hyun; Kwon, Jae Woo; Hwang, Seung Hyun; Hyeun, Chung; Park, Gui Suk; Park, Yejong; Park, Kwang-Min

doi:10.1007/s11605-018-3928-1

Cited by 26 publications

(33 citation statements)

References 45 publications

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“…In the published series, the recurrence risk is low and very low in 50-64% of cases [10,13]. The disease-free survival and the disease-specific survival of duodenal GISTs are significantly worse than those of gastric GISTs [10].…”

Section: Discussionmentioning

confidence: 96%

Duodenal GIST: Surgical treatment based on the location. A single center experience with review of the literature

Moya¹

2020

Journal of Surgery and Medicine

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The study was approved by the Ethic Committee of Arnau de Vilanova Hospital in Valencia (28/01/2020). All procedures in this study involving human participants were performed in accordance with the 1964 Helsinki Declaration and its later amendments. Etik Kurul Onayı: Çalışma Valencia'daki Arnau de Vilanova Hastanesi Etik Komitesi tarafından onaylandı (28/01/2020). İnsan katılımcıların katıldığı çalışmalardaki tüm prosedürler, 1964 Helsinki Deklarasyonu ve daha sonra yapılan değişiklikler uyarınca gerçekleştirilmiştir.

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Section: Discussionmentioning

confidence: 96%

Duodenal GIST: Surgical treatment based on the location. A single center experience with review of the literature

Moya¹

2020

Journal of Surgery and Medicine

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“…All GIST are potentially malignant even though they can have benign appearance [6]. Duodenal GIST are rare [1,7]. Median size of DGIST lesion is about 4 cm [6].…”

Section: Discussionmentioning

confidence: 99%

“…Leading symptoms are nonspecific abdominal pain, GIB (melena, hematemesis, hematochezia), and symptomatic anemia [1,7]. Clinical, histological as well as immunohistochemical features vary, depending on tumor location [1].…”

Section: Discussionmentioning

confidence: 99%

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Small gastrointestinal stromal tumour of the duodenum causing a life-threatening bleeding - A case report and review of the literature

Taskovska

Omejc

Grosek

2019

International Journal of Surgery Case Reports

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Highlights Gastrointestinal stromal tumours could be source of massive (life-threatening bleeding). If massive bleeding is present in patient with gastrointestinal stromal tumour, surgical treatment is indicated, without further diagnostics. Depending on location and size of GIST, extend of surgical treatment varies. En bloc resection is required, role of lymphadenectomy is not clear. In setting when patient is stable, diagnostic evaluation is performed first, to access size, location of tumour and plan best surgical approach. Treatment of gastrointestinal stromal tumours should be multidisciplinary.

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“…However, in most cases PD was considered too aggressive even for oncological reasons with "innocent" resection of pancreas and bile duct, 3 moreover, the reconstructions on un-dilated ducts were technically demanding and exerted great risks on postoperative complications. [2][3][4][5] Pancreas-sparing duodenectomy (PSD) with a negative margin was reported to be technically feasible and presumed to have more functional preservation, [3][4][5][6] while providing comparable recurrent rate, 5,6 and even better long-term prognosis. 2 Recently, more and more attempts were stressed on the indication and various surgical procedures, 2,5,7 however, no routine methods were established because of the limited cases.…”

Section: Introductionmentioning

confidence: 99%

<p>Optimal Laparoscopic Management and Oncological Outcomes of Gastrointestinal Stromal Tumors in Duodenum: Pancreaticoduodenectomy or Pancreas-Sparing Duodenectomy?</p>

Lü¹,

Jin²,

Mou³

et al. 2020

CMAR

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Background: Gastrointestinal stromal tumors (GIST) of the duodenum are rarely reported and optimal minimally invasive management has not been well proposed. Pancreaticoduodenectomy and different types of pancreas-sparing duodenectomy can be chosen; however, which to choose and its corresponding clinical outcomes and oncological concerns remain controversial. Patients and Methods: Patients diagnosed with GIST of duodenum underwent laparoscopic pancreaticoduodenectomy (L-PD) or pancreas-sparing duodenectomy (L-PSD) in Zhejiang Provincial People's Hospital were enrolled. All prospectively maintained data were analyzed retrospectively. Patients were grouped into the L-PD group or the L-PSD group, and the clinical outcomes and oncological outcomes were analyzed. Results: Between June 2013 and March 2019, a total of 22 patients (11 males/11 females) underwent surgical management, including 13 L-PDs and 9 L-PSDs. The average age was 58.2 ±9.5 year-old (median 60.5 year-old). The most common presentations were GI bleeding (54.5%) and abdominal discomfort (27.2%), and the dominant lesion located in the second portion of duodenum (59.1%). Compared with L-PD group, L-PSD group showed much shorter operation time (364.2±58.7min vs. 230.0±12.3min, P<0.001), less blood loss (176.9±85.7mL vs. 61.1±18.2min, P<0.001), faster recovery to off-bed (2.6±1.3d vs. 1.1±0.3d, P=0.003), anus flatus (4.5±1.0d vs. 2.4±0.5d, P<0.001) and liquid intake (4.9±1.3d vs. 2.3±0.5d, P<0.001). Lymph node retrieval was much less in L-PSD, but no lymph node metastasis was observed in any patients. L-PSD had much Lower morbidity of both minor (Grade I/II) and major (III/IV/V) complications than that of L-PD (11.1% vs. 61.6%, P=0.02), resulting in shorter hospital stays (10.9±3.8d vs. 20.6±11.1d, P=0.021) and less total cost (76,972.4±11,614.8yuan vs 125,628.7 ±46,356.8yuan, P=0.006). The median follow-up was 42 months (range from 12 to 82months) without loss. Only 1 L-PD patient suffered hepatic metastasis 36months after surgery, and given sunitinib to stabilize the disease, none of the rest observed recurrence or metastasis. Conclusion: For GIST located opposite the major papilla, L-PSD showed comparable safety and oncological benefits when compared to L-PD, with shorter operation time, less blood loss and much faster recovery time, resulting in much less total cost. L-PSD should be applied in selected patients with experienced hands.

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Clinicopathologic Characteristics and Optimal Surgical Treatment of Duodenal Gastrointestinal Stromal Tumor

Cited by 26 publications

References 45 publications

Duodenal GIST: Surgical treatment based on the location. A single center experience with review of the literature

Duodenal GIST: Surgical treatment based on the location. A single center experience with review of the literature

Small gastrointestinal stromal tumour of the duodenum causing a life-threatening bleeding - A case report and review of the literature

<p>Optimal Laparoscopic Management and Oncological Outcomes of Gastrointestinal Stromal Tumors in Duodenum: Pancreaticoduodenectomy or Pancreas-Sparing Duodenectomy?</p>

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