Surgical management of rectal gastrointestinal stromal tumors

Tielen, R.; Verhoef, Cornelis; Coevorden, Frits van; Reyners, Anna K.L.; Graaf, Winette T.A. van der; Bonenkamp, Johannes J.; Etten, Boudewijn van; Wilt, Johannes H. W. de

doi:10.1002/jso.23223

Cited by 64 publications

(66 citation statements)

References 13 publications

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“…Our cohort of patients was predominantly male (73.3%), which is similar to data in other studies [9,10]. The tumor size of rectal GISTs patients was small with a median size of 5 cm, which was in agreement with the data obtained by Jakob et al [15].…”

Section: Discussionsupporting

confidence: 92%

“…This marker is expressed in more than 90% of stromal tumors. Tielen et al [10] reported that 32 patients with rectal GISTs had 88% CD117-positive expression rate. Furthermore, high positive expression of CD117 (93%) for this type of lesion was reported [14].…”

Section: Discussionmentioning

confidence: 99%

“…Surgeons currently select the surgical procedure based on the tumor location, but no standardized guidelines for selection are available. The available literature on rectal GISTs is limited to date; most studies on rectal GISTs have small sample sizes [10][11]. In the current study, we aimed to evaluate the clinicopathological characteristics, surgical management, and long-term outcomes of rectal GISTs of patients from a single medical institution.…”

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confidence: 99%

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Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Shen¹,

CHEN²,

Yin³

et al. 2015

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Rectal gastrointestinal stromal tumors (GISTs) are rare, and limited information is available concerning their management and long-term outcomes. We retrospectively evaluated the clinicopathological characteristics, surgical management, and long-term outcomes of rectal GISTs from a single institution.All surgically treated patients with rectal GISTS at the Department of General Surgery, West China Hospital, Sichuan University were identified between January 2005 and May 2014. The overall survival (OS) and disease-free survival (DFS) were assessed by the Kaplan-Meier method.Forty-five patients with rectal GISTs (33 males and 12 females) were identified. Patients presented with rectal bleeding (n = 13; 28.9%) and altered bowel habits (n = 11; 24.4%). The cohort study of 45 patients included 4 very low-risk, 10 lowrisk, 1 intermediate-risk, and 30 high-risk patients. A total of 21, 13, and 11 patients underwent local resection (Group 1), abdominoperineal resection (Group 2), and super-low or low anterior resection (Group 3), respectively. Group 1 had a smaller tumor sizes and shorter distances from the anal verge compared with the other groups (P < 0.05). The one-, three-, and fiveyear DFS rates for the entire cohort study were 90.4%, 69.3%, and 57.0%, respectively. High National Institutes of Health (NIH) risk categories (HR = 1.62) were associated with low DFS rates (P = 0.035). The DFS was significantly improved by imatinib mesylate (IM) adjuvant therapy in the high-risk subgroup (P = 0.001).The type of surgery should be chosen based on the location and size of the rectal GISTs. Adjuvant IM therapy was associated with improved DFS in patients with high-risk tumors, and classification was strongly associated with the patient outcome.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Shen¹,

CHEN²,

Yin³

et al. 2015

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“…Thus, those GISTs arising in anatomically compromised locations would be a preferred target population, and particularly rectal GISTs, that usually have responsive KIT exon 11 mutations and involve challenging surgeries [Jakob et al 2013;Tielen et al 2013].…”

Section: Neoadjuvant Imatinib In Gistsmentioning

confidence: 99%

Recent advances in the treatment of gastrointestinal stromal tumors

Serrano

George

2014

Ther Adv Med Oncol

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Constitutively activating mutations in the KIT and platelet-derived growth factor receptor α (PDGFRA) RTKs play a crucial role in the biology of gastrointestinal stromal tumors (GISTs), and this disease has served as an effective model for targeting gain-of-function kinase mutations in cancer. Imatinib has entered the clinical arena in the last decade and substantially improved the outcome in these formerly untreatable cancers. However, most advanced GISTs responding to imatinib progress within 2-3 years due to heterogeneous subclones harboring a range of imatinib-resistant secondary KIT mutations. Sunitinib, and more recently, regorafenib, have obtained US Food and Drug Administration approval for the treatment of GISTs after imatinib failure, and thus expanded the treatment options in resistant disease. Within this framework, we present an evaluation of current GIST management, emphasizing the most recent advances in the field together with a discussion on future steps to be taken in refractory disease.

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“…In selected cases preoperative imatinib treatment may reduce tumour size and facilitate surgery, especially when GIST is located in the rectum [2,3] or when gastric GIST is large in size [4]. Preoperative imatinib may allow organ sparing and preserve the gastrointestinal tract function and continuity.…”

Section: Introductionmentioning

confidence: 99%

Needle biopsy through the abdominal wall for the diagnosis of gastrointestinal stromal tumour – Does it increase the risk for tumour cell seeding and recurrence?

Eriksson

Reichardt

Hall

et al. 2016

European Journal of Cancer

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Purpose: Preoperative percutaneous transabdominal wall biopsy may be considered to diagnose gastrointestinal stromal tumour (GIST) and plan preoperative treatment with tyrosine kinase inhibitors when an endoscopic biopsy is not possible. Hypothetically, a transabdominal wall biopsy might lead to cell seeding and conversion of a local GIST to a disseminated one. We investigated the influence of preoperative needle biopsy on survival outcomes. Methods: We collected the clinical data from hospital case records of the 397 patients who participated in the Scandinavian Sarcoma Group (SSG) XVIII/Arbeitsgemeinschaft Internistische Onkologie (AIO) randomised trial and who had a transabdominal fine needle and/or core needle biopsy carried out prior to study entry. The SSG XVIII/AIO trial compared 1 and 3 years of adjuvant imatinib in a patient population with a high risk of GIST recurrence

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Surgical management of rectal gastrointestinal stromal tumors

Abstract: Preoperative imatinib leads to downsizing of the tumors in Group 1. However, it has not led to less extensive surgery. The DFS is longer in patients treated with pre- and post-operative imatinib, without an effect on OS.

Cited by 64 publications

References 13 publications

Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Clinicopathologic, surgical characteristics and survival outcomes of rectal gastrointestinal stromal tumors

Recent advances in the treatment of gastrointestinal stromal tumors

Needle biopsy through the abdominal wall for the diagnosis of gastrointestinal stromal tumour – Does it increase the risk for tumour cell seeding and recurrence?

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