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World Journal of Surgery
Published in: World Journal of Surgery 1/2006

01-01-2006

Surgical Management of Small Gastrointestinal Stromal Tumors of the Stomach

Authors: Makoto Iwahashi, MD, Katsunari Takifuji, MD, Toshiyasu Ojima, MD, Masaki Nakamura, MD, Mikihito Nakamori, MD, Yoshihiro Nakatani, MD, Kentaro Ueda, MD, Koichiro Ishida, MD, Teiji Naka, MD, Kazuo Ono, MD, Hiroki Yamaue, MD

Published in: World Journal of Surgery | Issue 1/2006

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Abstract

Small gastrointestinal stromal tumors (GISTs) (<3 cm) occasionally are found in the stomach during endoscopy. There is no consensus about the surgical management of these small tumors, although this clinical issue is crucial because some of the tumors show unexpected malignant behavior. In this study, we evaluated the clinical management of patients with gastric GISTs who underwent surgical resection. Altogether, 31 patients with gastric GISTs were examined retrospectively. Surgical resection was fundamentally indicated for the patients with gastric GISTs suspected to be malignant by endoscopy or endoscopic ultrasonography (EUS). The malignant grade of the GISTs was evaluated by the mitotic rate, tumor size, and MIB-1 index. EUS was useful for differentiating benign from malignant GISTs; but by limiting the study to patients with small tumors (<3 cm), the diagnostic value of EUS was not satisfactory for defining the surgical indication. Tumors that were <50 mm were successfully treated by laparoscopic surgery. Of the 31 patients, 4 had a relapse of the disease, and 1 of those 4 patients had a small tumor (30 mm). All of the recurrences were classified in the high risk category. Surgery is indicated for gastric GISTs that are ≥20 mm or are suspected to be malignant based on EUS findings. Laparoscopic resection is feasible and is recommended as the treatment of choice for patients with tumors < 50 mm. Risk assessment can be most useful for predicting recurrence.
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Metadata
Title
Surgical Management of Small Gastrointestinal Stromal Tumors of the Stomach
Authors
Makoto Iwahashi, MD
Katsunari Takifuji, MD
Toshiyasu Ojima, MD
Masaki Nakamura, MD
Mikihito Nakamori, MD
Yoshihiro Nakatani, MD
Kentaro Ueda, MD
Koichiro Ishida, MD
Teiji Naka, MD
Kazuo Ono, MD
Hiroki Yamaue, MD
Publication date
01-01-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 1/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-7944-4

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