Gastrointestinal Stromal Tumors, Version 2.2014

Mehren, Margaret von; Randall, R. Lor; Benjamin, Robert S.; Boles, Sarah G; Bui, Marilyn M.; Casper, Ephraim S.; Conrad, Ernest U.; DeLaney, Thomas F.; Ganjoo, Kristen N.; George, Suzanne; Gonzalez, Ricardo J.; Heslin, Martin J.; Kane, John M.; Mayerson, Joel L.; McGarry, Sean V.; Meyer, Christian F.; O’Donnell, Richard J.; Pappo, Alberto S.; Paz, I. Benjamin; Pfeifer, John D.; Riedel, Richard F.; Schuetze, Scott M.; Schupak, Karen D.; Schwartz, Herbert S.; Tine, Brian A. Van; Wayne, Jeffrey D.; Bergman, Mary Anne; Sundar, Hema

doi:10.6004/jnccn.2014.0080

Cited by 115 publications

(105 citation statements)

References 25 publications

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“…Imatinib treatment may be considered preoperatively in order to inhibit tumor activity, and works by minimizing the tumor load and eliminating potential satellite lesions (21). Post-operatively, imatinib may be administered for adjuvant treatment for patients with a high recurrence risk, which is similar to the guidelines for their alimentary counterparts (22). Although imatinib exhibits a satisfactory curative effect in certain cases (11,16), the clinical value of imatinib on primary liver GISTs requires verification.…”

Section: Discussionmentioning

confidence: 99%

Primary gastrointestinal stromal tumor of the liver: A case report and review of the literature

et al. 2016

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Abstract. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. A small portion of GISTs are observed in extra-gastrointestinal regions, primarily in the omentum, mesentery and retroperioneum, and these types of GISTs are referred to as extra-gastrointestinal stromal tumors. The present study reports of a patient with unique primary liver GIST. The patient underwent en bloc resection and post-operative administration of imatinib, and subsequently experienced a good prognosis. The present case is followed by a brief review of reported cases of liver GISTs identified in the literature. The literature revealed that primary liver GISTs are usually large in size and possess a high mitotic index, which contributes to malignant characterization, thus classifying these tumors as high-risk. En bloc resection remains the mainstay of treatment for resectable primary liver GISTs. However, the prognosis of these patients is not favorable. Perioperative administration of imatinib may be useful to a certain extent, and interventional therapy, including radiofrequency ablation, should be considered.

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Section: Discussionmentioning

confidence: 99%

Primary gastrointestinal stromal tumor of the liver: A case report and review of the literature

et al. 2016

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“…There are certain differences in the follow-up examinations after surgery for GISTs between the guidelines of the National Comprehensive Cancer Network (NCCN) and the Japanese Society of Clinical Oncology (JSCO) (14,15). After surgical resection of all tumors, the NCCN guidelines recommend abdominal and pelvic CT imaging every 3-6 months for 3-5 years.…”

Section: Discussionmentioning

confidence: 99%

Emergency surgery for hemorrhagic shock caused by a gastrointestinal stromal tumor of the ileum: A case report

Shimazaki

Tabuchi

Nishida

et al. 2016

Molecular and Clinical Oncology

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Abstract. In this report, a case of hemorrhagic shock caused by a gastrointestinal stromal tumor (GIST) of the ileum, which was successfully treated by emergency surgery, is presented. A 67-year-old male patient presented to the Ibaraki Medical Center, Tokyo Medical University (Ami, Japan) in July 18, 2014, with dizziness and blood in the stool. Upper endoscopy and colonoscopy failed to reveal the source of the hemorrhage, although abdominal contrast-enhanced computed tomography revealed extravasation of the contrast medium into the small intestine. The patient developed hemorrhagic shock; thus, double-balloon enteroscopy (DBE) was performed, which revealed a Meckel's diverticulum and a submucosal tumor with excessive bleeding at 60 and 100 cm proximal to the ileocecal valve, respectively. Subsequent emergency partial resection of the ileum, including the tumor and the Meckel's diverticulum, was performed in July 20, 2014. Histological examination of the excised tumor revealed proliferation of spindle-shaped cells, and immunohistochemical staining of the tumor was positive for CD34, KIT and α-smooth muscle actin, but negative for S-100 protein. These immunohistological results supported the diagnosis of GIST of the ileum. The patient had an uneventful recovery and has been monitored at our outpatient clinic for 14 months after surgery. This case demonstrated the efficacy of DBE for the diagnosis of small intestinal bleeding, and immediate emergency surgery should be considered for cases of small intestinal GISTs with excessive bleeding. IntroductionGastrointestinal stromal tumors (GISTs) are rare tumors that may arise from any site of the GI tract and are generally associated with abdominal pain, GI bleeding, or a palpable mass. However, a small intestinal GIST rarely causes hemorrhagic shock. We herein report a case of hemorrhagic shock with excessive bleeding caused by an ileal GIST that was managed by emergency surgery. The patient provided written informed consent for the publication of this case report. Case reportA 67-year-old male patient presented to the Department of Gastroenterology of the Ibaraki Medical Center, Tokyo Medical University (Ami, Japan) in July 18, 2014, with dizziness and blood in the stool. The patient's medical history included treatment for hypertension by a local physician. The findings of the subsequent physical examination were unremarkable, except for low blood pressure (97̸60 mmHg) and mild pallor of the palpebral conjunctiva. Laboratory data revealed mild anemia (hemoglobin, 10.2 g̸dl) and increased blood urea nitrogen (34.1 mg̸dl). Upper endoscopy revealed no hemorrhagic lesion of the duodenum, stomach, or esophagus. Colonoscopy revealed fresh blood with clotting discharged from the proximal side of the ileocecal valve; no hemorrhagic lesion of the colon or rectum was identified. Abdominal contrast-enhanced computed tomography (CT) revealed extravasation of the contrast medium into the small intestine (Fig. 1). The intestinal bleeding continued, and the patient eventually devel...

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“…[5,7,8,9] Surgery accompanied by adjuvant radiotherapy as needed is the gold standard for achieving local control of STS. [3,5,7,[9][10][11][12] The role of chemotherapy in the cure of STS is underrecognized, but it is currently improving. [5,13] The aim of surgery and radiotherapy is local control of the STS, whereas the aim of chemotherapy is systemic control as curative, supportive, or palliative therapy.…”

Section: Introductionmentioning

confidence: 99%

“…[2,5,6] Some sarcomas are more likely to develop with genetic syndromes that have been associated with the pathogeny of STS, such as retinoblastoma syndrome, Li-Fraumeni syndrome, and familial adenomatous polyposis. [2,3,5,6] Recent studies have indicated that grade, tumor size, surgical margins, histology, location, radiotherapy, age, and sex are important prognostic factors for STS. [5,7,8,9] Surgery accompanied by adjuvant radiotherapy as needed is the gold standard for achieving local control of STS.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] The incidence of STS has been increasing in recent years, most probably as a result of the increase in Kaposi's sarcoma as well as enhanced diagnosis capacity. [4] This nonhomogeneous group of mesenchymal tumors may originate from soft tissue or several organs, and the classification includes adipocytic tumors, vascular tumors, endothelial tumors, and fibroblastic tumors, as well as those of smooth muscle and skeletal muscle.…”

Section: Introductionmentioning

confidence: 99%

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Using Different Parts Of Surgical Gloves For Non-Absorptive Drainage Of Fingers In Hand Surgery

Akgun¹

2016

Kartal TR

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Objective: Soft tissue sarcoma (STS) is a very rare, heterogeneous, solid tumor of mesenchymal origin that accounts for about 1% of adult malignancies and 15% of pediatric malignancies. The aim of this study was to analyze the data of STS patients who were treated with surgery and preoperative radiotherapy, postoperative radiotherapy, or chemotherapy between 2010 and 2017 for prognostic factors. Methods:The study included 22 patients with a diagnosis of any type of STS who were treated at a training and research hospital between 2010 and 2017. Data regarding patient age and sex, histological type of the tumor, tumor size, tumor localization, tumor grade, time of radiotherapy (preoperative or postoperative), prescribed radiation dose, chemotherapy treatment regime, length of follow-up, survival, and recurrence of the tumor were analyzed.Results: A total of 22 patients with a mean age of 60.5±16.2 years (range: 34-86 years) were included in the study. In all, 54.5% of the group had a high-grade sarcoma. The mean follow-up for all 22 patients was 34.1±22.4 months (range: 5-98 months), with a median of 28.0 months. The mean overall survival (OS) was 82.3±8.3 months (range: 66.0-98.6). The 3-year OS rate was 78.4%. The mean recurrence-free survival (RFS) was 72.5±8.8 months (range: 55.0-89.5 months) and the 3-year RFS rate was 69.3%. Conclusion:The OS was lower in the group that received chemotherapy and in cases of larger tumors. Preoperative or postoperative administration of radiotherapy did not have any significant effect on OS or RFS. Studies with larger samples are needed to further define the effects of radiotherapy and chemotherapy on OS and complications.

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Gastrointestinal Stromal Tumors, Version 2.2014

Cited by 115 publications

References 25 publications

Primary gastrointestinal stromal tumor of the liver: A case report and review of the literature

Primary gastrointestinal stromal tumor of the liver: A case report and review of the literature

Emergency surgery for hemorrhagic shock caused by a gastrointestinal stromal tumor of the ileum: A case report

Using Different Parts Of Surgical Gloves For Non-Absorptive Drainage Of Fingers In Hand Surgery

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