Published in:
01-10-2010 | Original Article
Long-Term Clinical Outcome of Patients with Gastric Gastrointestinal Stromal Tumors
Published in: Digestive Diseases and Sciences | Issue 10/2010
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Background
About 10–30% of gastrointestinal stromal tumors prove to be malignant. Nevertheless, the natural history of gastric gastrointestinal stromal tumors has not been fully elucidated.
Aims
To determine the long-term clinical outcome of nonresected gastric gastrointestinal stromal tumors.
Methods
Clinical follow-up of patients with endosonographic characteristics compatible with gastric gastrointestinal stromal tumors was conducted based on Israeli population registry. Lesions with features suggesting malignancy were usually referred to surgery. Follow-up endoscopic ultrasound examinations of nonoperated patients were reviewed.
Results
Seventy-one patients with presumable gastric gastrointestinal stromal tumors were followed. Seventeen patients underwent operation; median tumor size was 43 mm (range 29–70 mm). Within a median of 43 months (range 2–131 months) ten patients died of causes unrelated to gastrointestinal stromal tumor. Forty-four patients with endosonographic diagnosis of gastric gastrointestinal stromal tumors were followed expectantly for a median of 12 years (range 5–15 years). All these patients are alive and without complications associated with gastrointestinal stromal tumor. Follow-up endoscopic ultrasound examinations demonstrated no change in tumor size in six, decrease (by 1–5 mm) in six, and increase (by 2–21 mm) in eight.
Conclusions
Therapeutic decisions guiding surgical interventions may be based on clinical presentation, comorbidity, and endosonographic characteristics. Nonoperated patients may be safely followed conservatively.