Efficacy and Safety of Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract

Marcella, Cicilia; Sarwar, Shakeel; Ye, Hui; Shi, Rui

doi:10.5946/ce.2019.121

Cited by 7 publications

(10 citation statements)

References 42 publications

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“…Surgery is the treatment of choice, but various endoscopic resection modalities are being more and more tried. Surgery is the treatment of choice for symptomatic localized GIST [ 18 - 19 ]. Endoscopic therapy is mainly used for the treatment of GISTs of the upper digestive tract in patients without recurrence or metastasis [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Massive Digestive Hemorrhagia Revealing a Gastro-Intestinal Stromal Tumor of the Jejunum

Cherouaqi

Belabbes

Delsa

et al. 2021

Cureus

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Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that originate from Cajal cells located in different sites of the digestive system. They may occur in the entire gastrointestinal tract. They are diagnosed on the basis of the identification of c-kit-positive cells. We report a case of a stromal tumor of the jejunum revealed by a massive digestive hemorrhagia. Surgical resection is the basis of the treatment of GISTs. Imatinib, a tyrosine kinase inhibitor, is a beneficial treatment after surgical resection of high-risk GISTs.

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Section: Discussionmentioning

confidence: 99%

Massive Digestive Hemorrhagia Revealing a Gastro-Intestinal Stromal Tumor of the Jejunum

Cherouaqi

Belabbes

Delsa

et al. 2021

Cureus

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“…Endoscopic treatment is mainly used for the treatment of GISTs of the upper GI tract for patients with no recurrence or metastasis[ 62 ]. The available endoscopic resection methods include endoscopic enucleation, endoscopic band ligation (EBL), endoscopic submucosal dissection (ESD), endoscopic submucosal excavation (ESE), submucosal tunneling endoscopic resection (STER), endoscopic full-thickness resection (EFTR), and laparoscopic and endoscopic cooperative surgery (LECS)[ 63 - 71 ].…”

Section: Endoscopic Resectionmentioning

confidence: 99%

Recent advances in the management of gastrointestinal stromal tumor

Ahmed¹

2020

WJCC

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Gastrointestinal stromal tumor (GIST) is a rare but an important clinical entity seen in our clinical practice. It is the most common mesenchymal tumor of the gastrointestinal tract and most common malignancy of the small intestine. Although the exact prevalence of GIST is not known, the incidence of GIST has been increasing. GISTs arise from interstitial cells of Cajal. Most of the GISTs occur due to mutation in c-kit gene or platelet derived growth factor receptor alpha gene. 15% of GISTs do not have these mutations and they are called wild-type GISTs. Almost all GISTs express KIT receptor tyrosine kinase. Histologically, GISTs look like spindle cell tumors most of the time but they can be epitheloid or mixed type. The median size of GISTs varies from 2.7 cm to 8.9 cm. Clinically, patients with small GISTs remain asymptomatic but as the GIST size increases, patients present with various symptoms depending on the location of the GIST. Most of GISTs are located in the stomach or small bowel. Diagnosis is suspected on imaging and endoscopic studies, and confirmed by tissue acquisition with immunohistochemical staining. The aggressiveness of GISTs depends on the size, mitotic index and location. Surgical resection is the treatment of choice. But various endoscopic modalities of resection are increasingly being tried. Tyrosine kinase inhibitors are extremely useful in the management of large GISTs, unresectable GISTs and metastatic GISTs. Treatment options for metastatic GISTs also include radiotherapy, chemotherapy, hepatic artery embolization, chemoembolization and radiofrequency ablation.

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“…4,5 In this issue of Clinical Endoscopy, Marcella et al introduced endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFTR), and submucosal tunneling endoscopic resection (STER) as endoscopic methods for removing GISTs, with favorable outcomes. 6 Endoscopic treatment (ET) attained a 100% en bloc resection rate, 77.4% complete resection rate, and 8.3% complication rate. Eight patients in the ESD group showed apparent adverse events such as intraoperative perforation (n= 7) and massive bleeding (n = 1).…”

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confidence: 99%

“…However, it is preferred for the resection of larger tumors and achieves a sufficient negative resection margin. 6 In this issue of Clinical Endoscopy, Marcella et al 6 indicated that ET is a feasible and favorable alternative option for surgery for GISTs even if they are large (3 cases, > 5 cm included). However, the resection of large GISTs using ET remains controversial, and no consensus has been reached.…”

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confidence: 99%

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Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract

Yoo

Cho

2020

Clin Endosc

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Gastrointestinal stromal tumors (GISTs) are the most common malignant subepithelial tumors (SETs) of the gastrointestinal tract. They originate from the intestinal cells of Cajal. Currently, the diagnosis of GISTs is based on immunohistochemical staining for c-kit protein and CD34, which are expressed in > 80% of GISTs. 1 GISTs must be differentiated from other SETs because of the malignancy potential of GISTs. According to the current guidelines, surgery is recommended for gastric GISTs of > 2 cm in size, and endoscopic surveillance is recommended for GISTs of < 2 cm in size. 2 However, even if the size of a GIST is small and the probability of malignancy is low, up to 3.7% of small GISTs (< 2 cm) are reported to have a high risk or an unexpected increase in size. 2,3 Furthermore, the regular surveillance strategy involves some risks, including delayed diagnosis of the malignancy of the disease, complications arising from repetitive endoscopy, and poor patient compliance. In addition, patients must bear the financial burden or emotional stress of follow-up. For patients who are reluctant to undergo surgery, endoscopic resection may be a better option than surgery. Endoscopic resection techniques have many ad-COMMENTARY

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Efficacy and Safety of Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract

Cited by 7 publications

References 42 publications

Massive Digestive Hemorrhagia Revealing a Gastro-Intestinal Stromal Tumor of the Jejunum

Massive Digestive Hemorrhagia Revealing a Gastro-Intestinal Stromal Tumor of the Jejunum

Recent advances in the management of gastrointestinal stromal tumor

Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract

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