Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

Zhang, Shuisheng; Tian, Yuan; Chen, Yingtai; Zhang, Jianwei; Zheng, Chao; Wang, Chengfeng

doi:10.1159/000488008

Cited by 11 publications

(10 citation statements)

References 35 publications

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“…Based on the results of this study, the clinicopathological parameters of our patients were similar to the basic characteristics of DGISTs in China[ 16 , 17 ]. There were no differences in the incidence rate between different genders with a median age of 62.15 years (range, 26–87 years).…”

Section: Discussionmentioning

confidence: 75%

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

et al. 2021

WJGO

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BACKGROUND Duodenal gastrointestinal stromal tumor (DGIST) is a rare tumor with a specific anatomic site and biological characteristics. As the incidence of lymph node metastasis is very low, the main treatment method is surgery. Two main surgical techniques (local resection and Whipple) are performed in patients with DGISTs. The critical question is which surgical technique to choose. AIM To identify factors influencing the choice of surgery for DGISTs. METHODS The clinicopathological data of patients with DGISTs who underwent surgery between January 1999 and January 2021 were analyzed. We used the Student’s t -test or Mann-Whitney U -test and the χ 2 test or Fisher’s exact test to determine the differences between the two groups of patients. Furthermore, we used logistic analysis to identify the relevant factors and independent factors related to the type of surgery. The Kaplan-Meier method was used to analyze the patient’s survival information and Cox regression analysis was performed to determine prognostic risk factors. RESULTS Overall, 86 patients were analyzed, including 43 men (50%) and 43 women (50%). We divided the patients into two groups based on surgical technique (local resection or Whipple surgery). There were no differences in the age, mitotic figures, and complications between the two groups; however, the tumor size, tumor location, risk grade, postoperative hospital stay, and abdominal drainage time were significantly different. Based on univariate logistic analysis, the Whipple procedure was chosen if the tumor size was ≥ 5.0 cm, the tumor was located in the descending part of the duodenum, or the risk grade was medium or high. In our research, the five-year overall survival rate of patients was more than 90%. We also describe two DGIST patients with liver metastases at first diagnosis and analyzed their management in order to provide advice on complicated cases. CONCLUSION The Whipple procedure was performed if the primary tumor was in the descending part of the duodenum, tumor size was ≥ 5.0 cm, or the tumor risk grade was medium or high.

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Section: Discussionmentioning

confidence: 75%

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

et al. 2021

WJGO

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“…In this case, the age of diagnosis was lower than average. Duodenal involvement by this kind of tumour is rare, and the tumors have been associated with neurofibromatosis type 1 [4] , [5] .…”

Section: Discussionmentioning

confidence: 99%

“…Most GISTs are circumscribed, solitary, rounded, or ovoid masses. Both benign and malignant GISTs have similar macroscopic appearances, thus preventing the categorization of biologic behavior based on gross configuration [4] , [5] . Histologically, most GISTs fall into one of the following three categories: spindle cell type (70%), as it was the case in our patient, epithelial type (20%), or mixed type (10%) [1] .…”

Section: Discussionmentioning

confidence: 99%

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An incidental finding of duodenal GIST in a patient with penetrating abdominal trauma: A case report

Pyuza

Shao

Bosco

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Duodenal Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the digestive tract. The tumors are derived from interstitial cells of Cajal and usually they present as gastrointestinal bleeding or non-specific abdominal pain, but they can also be asymptomatic even when they have reached considerable size. Case presentation We report a case of a 40-year-old male presented to our emergency department after sustaining a stab wound on the abdomen. Abdominal imaging tests weren't done; instead an emergency laparotomy was undertaken upfront in an attempt to catch up with a “golden hour”. Intra-operatively, an incidental solid mass measuring 4 × 5 cm was noted on the third/fourth portion of the interior duodenal flexure. Histopathologically, the lesion demonstrated spindled shaped cells which were immunopositive for positive CD117. The patient fared well postoperatively and during subsequent follow up visits. Clinical discussion High-risk GISTs have malignant potential. In some cases, GIST is diagnosed as incidentally finding, mostly during surgical procedure, upper endoscopy or radiological studies related to GI tract. Surgical resection is recommended curative option and its extension depends on different factors. Tyrosine kinase inhibitors are of the utmost importance in high-risk and metastatic disease. Conclusion Even considerably large duodenal GISTs can be asymptomatic, thus incidentally found during an abdomino-pelvic imaging tests. Histopathological evaluation of the operative specimen plays a key role in assessing the need of adjuvant therapy, with a significant impact on the patients' survival.

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“…Duodenal gastrointestinal stromal tumours (DGISTs) are independent undifferentiated mesenchymal tumours, and they only account for 2-5% of all gastrointestinal stromal tumours [1][2][3][4][5]. Surgical resection is the most effective treatment for DGIST [6,7].…”

Section: Introductionmentioning

confidence: 99%

Robotic Resection of Duodenal Gastrointestinal Stromal Tumour: Preliminary Experience from a Single Centre

Zhou

Tan

Zhao

et al. 2021

Preprint

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Background: The experience of minimally invasive surgery in the treatment of duodenal gastrointestinal stromal tumours (DGISTs) is accumulating, but there is no consensus on the choice of surgical method. The purpose of this study is to summarize the technique and feasibility of robotic resection of DGIST.Methods: The demographics and perioperative outcomes of a consecutive series of patients who underwent robotic resection and open resection of DGIST between May 1, 2010 and May 1, 2020 were retrospectively analysed. Patients were divided into an open surgery group and a robotic surgery group. Pancreaticoduodenectomy (PD) or limited resection was performed based on the location of the tumour and the distance between the tumour and duodenal papilla. Age, sex, tumour location, tumour size, operation time (OT), estimated blood loss (EBL), postoperative hospital stay (PHS), tumour mitosis, postoperative risk classification, postoperative recurrence and recurrence-free survival were compared between the two groups.Results: Among the 28 patients, there were 19 males and 9 females aged 51.3± 13.1 years. Limited resection was performed in 17 patients, and PD was performed in 11 patients. Eleven patients underwent open surgery, and 17 patients underwent robotic surgery. Two patients in the robotic surgery group underwent conversion to open surgery. All the tumours were R0 resected, and there was no significant difference in age, sex, tumour size, operation mode, PHS, tumour mitosis, incidence of postoperative complications, risk classification, postoperative targeted drug therapy or postoperative recurrence between the two groups (p>0.05). OT and EBL in the robotic group were significantly different from those in the open surgery group (p<0.05). All the patients survived during the follow-up period, and 4 patients had recurrence and metastasis. No significant difference in recurrence-free survival was noted between the open surgery group and the robotic surgery group (p>0.05).Conclusions: Robotic resection is safe and feasible for patients with duodenal gastrointestinal stromal tumours, and its therapeutic effect is equivalent to open surgery.

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Clinicopathological Characteristics, Surgical Treatments, and Survival Outcomes of Patients with Duodenal Gastrointestinal Stromal Tumor

Cited by 11 publications

References 35 publications

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors

An incidental finding of duodenal GIST in a patient with penetrating abdominal trauma: A case report

Robotic Resection of Duodenal Gastrointestinal Stromal Tumour: Preliminary Experience from a Single Centre

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