Diagnosis and Treatment of Duodenal Gastrointestinal Stromal Tumors

Du, Haojie; Ning, Longgui; Li, Sha; Lou, Xinhe; Chen, Hongtan; Hu, Fengling; Guo, Siyu; Zhang, Fenming; Xu, Guofan

doi:10.14309/ctg.0000000000000156

Cited by 10 publications

(12 citation statements)

References 27 publications

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“…The diagnosis of DGIST was confirmed by immunohistochemical staining. Inclusion criteria are as follows: (1) Patients who underwent laparotomy; (2) Patients with DGISTs, as proven by pathology or immunohistochemistry (CD117, CD34, DOG1 and Ki67); (3) The tumor was located in the duodenum, as confirmed by preoperative abdominal computed tomography scan, ultrasound, endoscopy, upper gastrointestinal barium swallow, and surgery; and (4) Patients with GIST synchronous with other malignancies were excluded[ 7 ]. The risk grade of DGIST was assessed by a pathologist.…”

Section: Methodsmentioning

confidence: 99%

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: Methodsmentioning

confidence: 99%

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

et al. 2021

WJGO

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“…All GISTs have malignant potential, which appears to be higher in those arising in the small intestine comparing to the gastric ones [8] , [9] . Histologically, the best known prognostic factors are tumour size and the mitotic index.…”

Section: Discussionmentioning

confidence: 99%

“…Tumors which are ≤2 cm in diameter with ≤5 mitoses per 50 high power fields are usually benign with good prognosis. GIST which are >5 cm or >5mitoses per 50 high power fields are likely to be malignant; and poor prognostic factors include tumour necrosis, extensive hemorrhage unrelated to surgery, hypercellularity, marked cellular atypia and epithelioid pattern with mucosal invasion [8] , [9] . About 30–50% of the GIST are malignant with 5 year survival of 50%; malignant tumors usually metastasize to liver and peritoneum [9] .…”

Section: Discussionmentioning

confidence: 99%

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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“…Большинство ГИСО спорадические, однако в 5% наблюдений их выявляют у пациентов с нейрофиброматозом I типа (НФ-1) и триадой Карнея [15]. Кли ническая картина неспецифична: симптомы желудочно-кишеч ного кровотечения (44,4%), следующие за абдоминальной болью и метеориз-мом (27,5%) [16]. В ДПК ГИСО чаще локализуются в сегментах D2 (52,1%) и D1 (19%) [16].…”

Section: обсуждение результатовunclassified

Computer-assisted and magnetic resonance imaging assessment of tumors and tumor invasion of the duodenum

Kаrmаzаnovsky

Abuladze²

2022

Ann. hir. gepatol.

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Aim: To present the computed tomography and magnetic resonance imaging assessments of benign and malignant duodenal tumors, pancreatic head adenocarcinoma invading the duodenum, and duodenal dystrophy.Methods: We searched for scientific papers and clinical guidelines in the information and analytical databases PubMed and Google Scholar from the 2013–2021 period using the following search terms: duodenal neoplasms, adenocarcinoma, duodenum, duodenal neuroendocrine tumors, duodenal adenoma, gastrointestinal stromal tumor, cholangiocarcinoma, radiology, magnetic resonance imaging, computed tomography, pancreatic head cancer. Then, we examined the reference lists of all the identified studies to collate the papers that would meet the eligibility criteria.Results: We analyzed 1494 articles, 22 of which were included in our review. From the papers published within 1992–2021, 35 articles from the reference lists were additionally included. Based on the search results, several domains of articles were clustered; the articles from those domains were reviewed and evaluated that involved the abovementioned diagnostic features.Conclusion: The early diagnosis and selection of appropriate management methods remain extremely relevant for the treatment of duodenal tumors, and hence, require careful attention from diagnosticians and clinicians.

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Diagnosis and Treatment of Duodenal Gastrointestinal Stromal Tumors

Cited by 10 publications

References 27 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

Computer-assisted and magnetic resonance imaging assessment of tumors and tumor invasion of the duodenum

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