Clinical trends and surgical outcome in management of gastrointestinal stromal tumors

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Our aim in this study is to find out clinical evaluation and surgical outcome in management of these types of tumors.

Patients and methods: 11 consecutive patients subjected to surgical treatment, diagnosed histopathologically as GISTs and enrolled in a prospective study from October 2007 to March 2011.

Results: 7 gastric and 4 small intestinal GISTs presented mainly by Gastrointestinal bleeding (36%) and abdominal pain (36%). 6 cases (55%) were discovered incidentally during laparotomy. All patients were managed surgically and confirmed by postoperative histopathologic study. Surgical resection with safety margin was done to all patients except one case with duodenal GIST was irresectable.

5 patients with poor prognostic factors and inoperable lesions required a second    therapy in Oncology Unit. During the follow up period (ranged from 6-34months) 2 patients died due to progression of the disease and distant metastasis.

Conclusion: GISTs are commonly diagnosed incidentally during laparotomy and most of them presented with gastrointestinal bleeding and abdominal pain .Complete surgical resection is the mainstay of their management. Urgent cases of GISTs carry poor prognosis, but further clinical trials are needed to establish this factor.

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Our aim in this study is to find out clinical evaluation and surgical outcome in management of these types of tumors.

Patients and methods: 11 consecutive patients subjected to surgical treatment, diagnosed histopathologically as GISTs and enrolled in a prospective study from October 2007 to March 2011.

Results: 7 gastric and 4 small intestinal GISTs presented mainly by Gastrointestinal bleeding (36%) and abdominal pain (36%). 6 cases (55%) were discovered incidentally during laparotomy. All patients were managed surgically and confirmed by postoperative histopathologic study. Surgical resection with safety margin was done to all patients except one case with duodenal GIST was irresectable.

5 patients with poor prognostic factors and inoperable lesions required a second    therapy in Oncology Unit. During the follow up period (ranged from 6-34months) 2 patients died due to progression of the disease and distant metastasis.

Conclusion: GISTs are commonly diagnosed incidentally during laparotomy and most of them presented with gastrointestinal bleeding and abdominal pain .Complete surgical resection is the mainstay of their management. Urgent cases of GISTs carry poor prognosis, but further clinical trials are needed to establish this factor.