Surgical resection for gastrointestinal stromal tumors (GIST): Experience on 25 patients

被引:18
作者
Boni L. [1 ]
Benevento A. [1 ]
Dionigi G. [1 ]
Rovera F. [1 ]
Dionigi R. [1 ]
机构
[1] Department of Surgery, University of Insubria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese
关键词
Imatinib; Complete Resection; Gastrointestinal Stromal Tumor; Risk Class; Mitotic Count;
D O I
10.1186/1477-7819-3-78
中图分类号
学科分类号
摘要
Background: Gastrointestinal stromal tumors (GIST) are infrequent and diagnosis and prognosis could be troublesome. We present short and long term results of surgical resection for GIST at the Department of Surgery, University of Insubria, during a period of 17 years. Material and methods: All patients' data, tumor characteristics, surgical procedure and survival data were analyzed retrospectively. Tumors were divided in risk classes using the classification proposed by Fletcher, based on tumor size and number of mitosis. Results: Between 1987 and 2004, 25 patients underwent surgical resection for GIST. Stomach was the most common site of localization. Complete resection was achieved in 88% cases, while in 12% radical resection was not possible. The mean tumor size was 9.2 cm (1.2-30 cm): <5 cm diameter in 14/25 cases (56%), 5-10 cm in 5/25 (20%) and >10 cm in 6/25 (24%). Mitotic count was <10/50 HPF in 68% (17/25) and >10/50 in 32% (8/25). Using Fletcher's classification, tumors were divided in very low (11/25, 44%), low (4/25, 16%), intermediate (6/25, 24%) and high-risk (4/25, 16%) groups. The 5-year overall survival was 65% and 34% respectively with a statistically significant difference between tumors <5cm and >10 cm in diameter and between complete and incomplete resection. High-risk tumors had a significantly shorter survival than low or very low risk. Conclusions: Our experience confirms that GIST's are uncommon and aggressive cancers. The prognosis is strictly related to tumor size and number of mitosis. Although significant advances on new chemotherapeutic regimes have been made, to date, only radical surgery offers the chance of long-term survival. © 2005 Boni et al., licensee BioMed Central Ltd.
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页数:23
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