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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2013 June;26(3):207-9
Gastric GIST and surgery
Galloro G., Sivero I., Donisi M., Bucci L., Sollazzo V., Benassai G., Quarto G., Formisano C.
Dipartimento di Chirurgia Generale, Geriatrica, Oncologica e Tecnologie Avanzate, Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, Napoli, Italia
Aim: Gastrointestinal stromal tumor (GIST) are mesenchimal tumor; they’re not common, but, by the way, they are estimated to be the most frequent gastrointestinal tumors. The incidence in USA is supposed to be around 5000-6000 per year; mean age varies between 50 and 60. Surgical treatment of resectable and localized GIST is the most effective cure; anyway there are multiple risk factors that might affect the prognosis. In order to eradicate the tumor, several surgical techniques are available, depending on the level of the affected gastrointestinal tract: the “wedge resection” is based on circumferentially excision of the lesion, in a tablet-fashion, with an adequate free-disease margin; on the other hand, sometimes major surgery is required, up to the need of a total gastrectomy or esophago-gastrectomy, which might also be enlarged to adjacent involved organs.
Methods: In this study 15 patients affected by gastric GIST have been analyzed; all of them underwent a surgical resection: in 6 patients a total gastrectomy was required, while all other patients underwent a distal gastroresection.
Results: Two patients showed a local and distant recurrence, which was treated with the Imatinib. One of these two patients has died during the follow up, while the other one is still alive.
Conclusion: This experience also confirms the adequacy of current guidelines, which are based on a strong relationship between surgical and medical management.