The Natural History of Gastrointestinal Subepithelial Tumors Arising From Muscularis Propria

Bruno, Mauro; Carucci, P.; Repici, Alessandro; Pellicano, Rinaldo; Mezzabotta, Lavinia; Goss, M.; Magnolia, M. R.; Saracco, Giorgio Maria; Rizzetto, M.; Angelis, Claudio De

doi:10.1097/mcg.0b013e31818f50b8

Cited by 29 publications

(27 citation statements)

References 24 publications

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“…They also found that the risk for enlargement was related to initial tumor size [17 mm (P = 0.018) [14]. These observations are confirmed in several other small studies [11,12].…”

Section: Discussionsupporting

confidence: 77%

“…More information on the natural history of GISTs can be glistened from natural history studies of small GISTs that are not removed [7,[10][11][12]. Studies by Gill et al and Chien et al and have shown that the majority of subepithileal tumors \3 cm including GISTs do not change in size with a mean follow-up of 20.7 and 23 months, respectively [7,10].…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Removal of Small Gastrointestinal Stromal Tumors: Can We GIST-ify the Risk?

2010

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“…They also found that the risk for enlargement was related to initial tumor size [17 mm (P = 0.018) [14]. These observations are confirmed in several other small studies [11,12].…”

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Endoscopic Removal of Small Gastrointestinal Stromal Tumors: Can We GIST-ify the Risk?

2010

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“…The management of GISTs that measure <2 cm in greatest dimension is more questionable. [57][58][59] Although the low risk of progression of GISTs that measure <2 cm offers the possibility of a more conservative approach, a reliable mitotic index cannot be determined by biopsy or fine-needle aspiration, thus preventing the identification of those at higher risk. Therefore, both observation and resection can well be considered for GISTs that measure from 1 cm to 2 cm in greatest dimension, and the risks and benefits of one versus the other should be discussed with the patient.…”

Section: Gastrointestinal Stromal Tumorsmentioning

confidence: 99%

Surgical management of localized soft tissue tumors

Gronchi

Colombo

Raut

2014

Cancer

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Soft tissue tumors are rare and can arise from a variety of soft tissues and viscera in a variety of body sites. Their management requires a thorough understanding of the biology of the different histologies and molecular subtypes as well as the constraints of specific anatomic sites. The surgical approach has undergone significant changes thanks to a better understanding of the natural history of the different histologic subtypes, the importance of site, and the different sensitivity to available drugs. The soft tissue tumor family includes 3 major, distinct categories: desmoid-type fibromatosis, soft tissue sarcoma, and gastrointestinal stromal tumor. In general, limb-sparing and function-sparing approaches should be used when feasible for tumors located in the extremities and girdles. Resections of adherent structures/viscera, which may be close but not invaded, may be needed in tumors arising in the retroperitoneum/abdomen to minimize microscopic intralesional margins, maximize local tumor control, and possibly improve survival. Margins of resection and the use of adjuvant/neadjuvant radiation therapy and/or chemotherapy are contingent on an accurate histologic diagnosis. Treatment planning should include multidisciplinary consultation to determine optimal therapy, taking into consideration tumor histology, site and extent of the disease, its natural history and sensitivity to available treatments, surgical challenges, and-of course-quality of life. Cancer 2014;120:2638-48.

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“…A significant increase in the size of an SET was defined as an increase of the longest diameter by more than 25% in the last EUS feature compared with the initial EUS examination. 15,16 All of the photographs of the enrolled SETs were reviewed by one skilled endoscopist.…”

Section: Eusmentioning

confidence: 99%

“…Unfortunately, there have been only a few studies analyzing the natural history of SETs using EUS examination. [19][20][21][22] In the current study, 11.4% of SETs less than 30 mm increased significantly in size during a mean period of 22.8 months. The proportion of significant growth was 9.5% and 12.5% in the esophagus and stomach, respectively.…”

mentioning

confidence: 99%

Analysis of Natural History of Upper Gastrointestinal Subepithelial Tumors and Factors Related to Tumor Growth Demonstrated by Endoscopic Ultrasonography

Han

Kim

Park

et al. 2016

Korean J Helicobacter Up Gastrointest Res

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Background/Aims: Small subepithelial tumors (SETs) are often found incidentally during esophagoduodenoscopy, and EUS is a useful tool for assessing SETs. This study aimed to evaluate the natural history of SETs and to clarify the predictive factors of growth using EUS. Materials and Methods: We retrospectively investigated SETs less than 30 mm and identified the EUS features. A significant increase in SET size was defined as a lengthening of more than 25% of the longest diameter in the last follow-up EUS features compared with the initial study. Results: A total of 99 patients with 105 upper gastrointestinal SETs were enrolled. The mean follow-up period for SETs was 22.8 months. Among the 105 SETs, 12 (11.4%) were significantly larger at follow-up. Univariate analysis revealed that the presence of hypoechoic areas was associated with significant SET growth (P=0.021). In multivariate analysis, the presence of hypoechoic areas (OR, 8.96; 95% CI, 1.89∼42.54) and anechoic areas (OR, 7.85; 95% CI, 1.09∼56.37) were related with significant growth of SETs. Six of the 12 SETs showing significant growth were removed, and identified as gastrointestinal stromal tumors. Conclusions: Majority of small SETs showed no significant increase during follow-up. Presence of hypoechoic areas and anechoic areas were associated with SET growth. Therefore, small SETs with hypoechoic area or anechoic area may be considered for regular

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The Natural History of Gastrointestinal Subepithelial Tumors Arising From Muscularis Propria

Abstract: Even small and benign-appearing lesions from muscularis propria may increase in size over time but this increase cannot be considered as an index of malignancy. As most of these lesions are GISTs, a policy of surveillance is advisable.

Cited by 29 publications

References 24 publications

Endoscopic Removal of Small Gastrointestinal Stromal Tumors: Can We GIST-ify the Risk?

Endoscopic Removal of Small Gastrointestinal Stromal Tumors: Can We GIST-ify the Risk?

Surgical management of localized soft tissue tumors

Analysis of Natural History of Upper Gastrointestinal Subepithelial Tumors and Factors Related to Tumor Growth Demonstrated by Endoscopic Ultrasonography

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