Surgical Management in Patients with Gastrointestinal Stromal Tumors: A Single-Center Experience

Tokumaru, Teppei; Okabayashi, Takehiro; Shima, Yasuo; Shibuya, Yasuyuki; Ozaki, Kazuhide; Sumiyoshi, Tatsuaki; Kozuki, Amane; Teraishi, Fuminori; Nakamura, Toshio; Matsumoto, Manabu; Iwata, Jun; Morita, Sojiro; Iiyama, Tatsuo

doi:10.1159/000445208

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…That is to say the postoperative recurrence rate remains high for high-risk patients, even their tumors have been completely removed. 35 Therefore, though the mean follow-up period was 25.5 months and we did not find recurrence and metastasis in this study, whether the robot is beneficial to long-term survival of gastric GISTs requires further study. In addition, evaluation of postoperative recurrence risk is crucial for the prognosis and subsequent imatinib adjuvant treatment.…”

Section: Discussionmentioning

confidence: 62%

Robotic Gastrotomy With Intracorporeal Suture for Patients With Gastric Gastrointestinal Stromal Tumors Located at Cardia and Subcardiac Region

Zhao

Wang²,

Jiang³

et al. 2018

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Purpose:Few studies of robotic gastric gastrointestinal stromal tumors (GISTs) resection have been conducted. This study was aimed to evaluate the robotic gastrotomy with intracorporeal suture for patients with GISTs located at cardia and subcardiac region.Materials and Methods:From January 2014 to August 2016, 11 patients with GISTs located at cardia and subcardiac region underwent robotic gastrotomy with intracorporeal suture. Data of these patients were collected.Results:The mean operative time was 82.7 minutes and the mean blood loss was 30.0 mL. No complication was reported. The postoperative length of stay was 3.3 days. On postoperative day 14, inflammation recovered to preoperative level. On postoperative month 6, the nutritional status was similar to that before the surgery. After 25.5 months follow-up, all patients survived with no recurrence or metastasis.Conclusions:Robotic gastrotomy with intracorporeal suture for patients with GISTs located at cardia and subcardiac region is safe and feasible.

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Section: Discussionmentioning

confidence: 62%

Robotic Gastrotomy With Intracorporeal Suture for Patients With Gastric Gastrointestinal Stromal Tumors Located at Cardia and Subcardiac Region

Zhao

Wang²,

Jiang³

et al. 2018

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…The definitive management for localized primary GIST (>2cm) is complete surgical excision 36 specially in younger patients and it is associated with better overall survival (OS) and GIST specific survival (GSS) when compared with surgical management in older patients (OS: 91.1% vs 77.2%, P = .01; GSS: 91.8% vs 78.0%, P = .008) 37 . Even in metastatic GISTs, surgery proved to be effective 38 . Nevertheless, Sato et al found no significant difference in the 5-year overall survival rate between patients who underwent R0/R1 and R2 resection (71.4 vs 68.6 %) 39 .…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological, immunohistochemical, molecular-genetic and risk profiles of gastrointestinal stromal tumors in a cohort of Sudanese patients

Husain¹,

Osman²,

Ahmed³

et al. 2023

Afr H. Sci.

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Background: Determining the risk of malignant behaviour and mutational status of gastrointestinal stromal tumours (GISTs) guide the management decision and allow optimal individualized patient treatment. Objectives: To determine clinicopathological, immunohistochemical (IHC), risk and KIT mutational findings of GISTs in Sudanese patients. Methods: Histological slides were reviewed, IHC for DOG-1 and CD117 performed and hotspot KIT mutations examined. The risk group was assigned using combined risk criteria. Results: 21 of the 36 patients (58.3%) were males (mean age, 54.83 ±12.57; range, 26-71). Abdominal pain and mass were the most frequent symptoms. Mean tumor size (±SD) was 11.6(±5.82) cm. Either CD117, DOG1 or both were positive in all cases. Using risk criteria, 33.3% (n=12) were clinically malignant at presentation, 13.9% (n=5) high risk, 16.7% (n=6) intermediate, 27.8% (n=10) low risk and 2.8% (n=1) very low risk. Sixteen of 23 (70%) tested cases had KIT (14 exon 11 and two exon 9) mutations. Six tumors were wild type. Exon 11 deletions (p.I563-L576 del and p.V559-N566delinsD) significantly correlate withdisease recurrence (p-value: 0.028). Conclusions: Sudanese patients with GIST tend to present late. Nearly half of them correspond to the malignant/high-risk category. The frequency of KIT mutations (79.31%) is in line with the literature. Keywords: Gastrointestinal stromal tumour; GIST; risk stratification; malignant behaviour; risk assessment; tumour rupture; metastasis; Imatinib; genotyping; KIT; DOG1.

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“…[123] The main laparoscopic surgical procedures include laparoscopic wedge resection (LWR), total gastrectomy and laparoscopic subtotal gastrectomy (LSG). [45] Among them, LWR is the most common laparoscopic surgery, in which the gastric tissue in the tumor is removed by a cutting and closing device, which is suitable for SMT of the anterior wall of the stomach. When the tumor is close to the pylorus or cardia, LWR can cause stenosis of the pylorus or cardia.…”

Section: Introductionmentioning

confidence: 99%

Comparison between laparoscopic and endoscopic resections for gastric submucosal tumors

Zhang

Huang

et al. 2019

Saudi J Gastroenterol

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Background/Aims: Open resection/laparoscopic resection (LR) is the traditional treatment of gastric submucosal tumor (G-SMT). The endoscopic resection (ER) technology provides good results for G-SMT treatment but lacks sufficient evidence-based evidence. This retrospective study aimed to compare the clinical efficacy of ER [endoscopic submucosal dissection (ESD), endoscopic submucosal excavation (ESE), and endoscopic full-thickness resection (EFR)] and LR [laparoscopic wedge resection (LWR) and laparoscopic subtotal gastrectomy (LSG)] for G-SMT. Patients and Methods: From January 2013 to January 2017, data of patients with G-SMT with tumor diameter <5 cm were collected from the database of The Affiliated Hospital of Qingdao University and classified based on surgical methods. Demographics, tumor characteristics, surgical outcomes, complications and tumor recurrence were recorded and compared. Results: Overall, 275 patients with G-SMT were enrolled: 152 underwent ER (ESD, n = 65; ESE, n = 23; EFR, n = 61) and 123 underwent LR (LWR, n = 93; LSG, n = 30). Age, sex, R0 resection rate, tumor location, type, recurrence and complications were not statistically significant ( P > 0.05). The ER group had a significantly higher percentage of intraluminal tumor (94.1% vs 62.4%) and smaller tumor size (1.8 ± 0.8 vs 3.4 ± 1.2 cm) than the LR group. The ER group had less muscular tumors than the LR group (54.6% vs 70.7%). The ER group had no serosal tumor. The ER group had shorter hospitalization time, postoperative hospital stay and diet recovery time. The LR group had shorter operation time, less cost and less blood loss. Conclusion: ER and LR are safe and effective treatments for SMT. For small intraluminally growing SMT, ER is better than LR.

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Surgical Management in Patients with Gastrointestinal Stromal Tumors: A Single-Center Experience

Cited by 4 publications

References 26 publications

Robotic Gastrotomy With Intracorporeal Suture for Patients With Gastric Gastrointestinal Stromal Tumors Located at Cardia and Subcardiac Region

Robotic Gastrotomy With Intracorporeal Suture for Patients With Gastric Gastrointestinal Stromal Tumors Located at Cardia and Subcardiac Region

Clinicopathological, immunohistochemical, molecular-genetic and risk profiles of gastrointestinal stromal tumors in a cohort of Sudanese patients

Comparison between laparoscopic and endoscopic resections for gastric submucosal tumors

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