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By Giovanni Gambino M.D. Ph.D.
Linda C Harlan, Jana Eisenstein, Maria C Russell, Jennifer L Stevens, Kenneth Cardona
OBJECTIVES: The National Cancer Institute (NCI) annually confirms therapy with treating physicians on a sample of patients diagnosed with a specific cancer. METHODS: Using the NCI Patterns of Care data, treatment patterns were examined on a population-based sample of patients diagnosed with gastrointestinal stromal tumors (GIST) in 2008. RESULTS: A random sample of 323 of 405 GIST patients registered in SEER was selected. Most patients had gastric GISTs, were ≥ 65 years, white, had private insurance, and treated in a hospital with a residency program...
May 2015: Journal of Surgical Oncology
M J Wilkinson, J E F Fitzgerald, D C Strauss, A J Hayes, J M Thomas, C Messiou, C Fisher, C Benson, P P Tekkis, I Judson
BACKGROUND: Gastrointestinal stromal tumours (GISTs) of the rectum often require radical surgery to achieve complete resection. This study investigated the management and outcome of surgery for rectal GISTs and the role of imatinib. METHODS: A cohort study was undertaken of patients identified from a database at one tertiary sarcoma referral centre over a continuous period, from January 2001 to January 2013. RESULTS: Over 12 years, 19 patients presented with a primary rectal GIST...
July 2015: British Journal of Surgery
Q Zhang, C-H Shou, J-R Yu, W-L Yang, X-S Liu, H Yu, Y Gao, Q-Y Shen, Z-C Zhao
BACKGROUND: This study evaluated the clinical characteristics, surgical procedures and prognosis of duodenal gastrointestinal stromal tumours (GISTs). METHODS: Patients with a diagnosis of primary duodenal GIST treated between January 2000 and December 2012 were analysed. Patients with gastric and small intestinal GISTs were chosen as control groups according to the following parameters: age, tumour size, mitotic index and adjuvant imatinib therapy. Operative procedures for patients with duodenal GIST included pancreaticoduodenectomy or limited resection...
July 2015: British Journal of Surgery
Jia-Qin Cai, Ke Chen, Yi-Ping Mou, Yu Pan, Xiao-Wu Xu, Yu-Cheng Zhou, Chao-Jie Huang
BACKGROUND: The aim of this study was to compared laparoscopic (LWR) and open wedge resection (OWR) for the treatment of gastric gastrointestinal stromal tumors (GISTs). METHODS: The data of 156 consecutive GISTs patients underwent LWR or OWR between January 2006 and December 2013 were collected retrospectively. The surgical outcomes and the long-term survival rates were compared. Besides, a rapid systematic review and meta-analysis were conducted. RESULTS: Clinicopathological characteristics of the patients were similar between the two groups...
May 9, 2015: BMC Surgery
Douglas Sborov, James L Chen
Non-GIST soft tissue sarcomas are a heterogeneous grouping of mesenchymal tumors that comprise less than 1% of adult malignancies. Treatment continues to be based on cytotoxic chemotherapy regimens. However, characterization of the molecular pathway deregulations that drive these tumors has led to the emergence of more customized treatment options. In this review, we focus on the multitude of molecular inhibitors targeting angiogenesis and cell cycle pathways being tested in clinical trials.
April 2015: Journal of Surgical Oncology
Mark Fairweather, Chandrajit P Raut
Intra-abdominal visceral sarcomas are a rare group of mesenchymal tumors that require the use of distinct surgical principles and a multidisciplinary approach in order to optimize treatment. Surgery remains the only potentially curative treatment. Management and outcomes vary for the different sarcomas arising from viscera. This review will summarize the current treatment strategies for the two most common visceral sarcomas, leiomyosarcomas, and gastrointestinal stromal tumors.
April 2015: Journal of Surgical Oncology
Moshim Kukar, Aditi Kapil, Wesley Papenfuss, Adrienne Groman, Stephen R Grobmyer, Steven N Hochwald
INTRODUCTION: Sparse information is available about GISTs in uncommon locations. Our large database analysis aims to determine the characteristics of GISTs in the esophagus, colon and rectum and compare to gastric GISTs. METHODS: The Surveillance Epidemiology and End Results (SEER) database was queried from 1990 to 2009 using CS SCHEMA v0203. Characteristics of each location were compared to gastric GISTs. RESULTS: 4411 GIST (29 esophageal, 2658 stomach, 1463 small intestine, 126 colonic, and 135 rectal) from 1990 to 2009 were identified...
May 2015: Journal of Surgical Oncology
M Matlok, M Stanek, M Pedziwiatr, P Major, J Kulawik, P Budzynski
BACKGROUND AND AIMS: Gastrointestinal stromal tumors are rare neoplasms of the gastrointestinal tract. These lesions are characterized by different levels of malignancy. Only radical surgery offers a chance of curing the disease. The aim of this study is to present the results of gastrointestinal stromal tumor treatment with minimally invasive surgery. MATERIAL AND METHODS: The study group included 27 patients operated laparoscopically on for gastrointestinal stromal tumor with laparoscopic surgery between September 2009 and December 2013...
September 2015: Scandinavian Journal of Surgery: SJS
Jaclyn Frances Hechtman, Ronald DeMatteo, Khedoudja Nafa, Ping Chi, Maria E Arcila, Snjezana Dogan, Alifya Oultache, Wen Chen, Meera Hameed
BACKGROUND: The incidence of other primary neoplasms in gastrointestinal stromal tumor (GIST) patients is relatively high. Our aim was to better characterize the clinicopathologic and molecular relationships in a cohort of GIST patients. METHODS: All GIST patients with tumor samples sent for molecular testing were identified via electronic medical records. Clinicopathologic characteristics of GIST and additional primary malignancies were analyzed. RESULTS: Of 260 patients, 50 (19 %) had at least one additional primary malignancy...
August 2015: Annals of Surgical Oncology
Jordi Rubió-Casadevall, Javier Martinez-Trufero, Xabier Garcia-Albeniz, Silvia Calabuig, Antonio Lopez-Pousa, Javier Garcia Del Muro, Joaquin Fra, Andrés Redondo, Nuria Lainez, Andrés Poveda, Claudia Valverde, Ana De Juan, Isabel Sevilla, Antonio Casado, Raquel Andres, Josefina Cruz, Javier Martin-Broto, Joan Maurel
BACKGROUND: Recurrent, metastatic, and locally advanced gastrointestinal stromal tumors (GISTs) can be treated successfully with imatinib mesylate. Surgery for residual disease has been suggested for nonrefractory metastatic GISTs to reduce the probability of resistant recurrent clones, although no randomized Phase III trial has been performed to answer the question about its benefit. We carried out an analysis of the outcome of patients with recurrent unresectable locally advanced or metastatic imatinib-sensitive priamary GIST in 14 institutions in Spain...
September 2015: Annals of Surgical Oncology
Ming Wang, Jia Xu, Yun Zhang, Lin Tu, Wei-Qing Qiu, Chao-Jie Wang, Yan-Ying Shen, Qiang Liu, Hui Cao
BACKGROUND: Gastrointestinal stromal tumor (GIST) is known for its wide variability in biological behaviors and it is difficult to predict its malignant potential. The aim of this study is to explore the characteristics and prognostic factors of GIST. METHODS: Clinical and pathological data of 497 GIST patients in our center between 1997 and 2012 were reviewed. RESULTS: Patients were categorized into very low-, low-, intermediate- and high-risk groups according to modified National Institutes of Health (NIH) consensus classification system...
2014: BMC Surgery
Kyoichi Ogata, Erito Mochiki, Hitoshi Ojima, Norihiro Haga, Minoru Fukuchi, Ryuusuke Aihara, Hiroyuki Ando, Nobuyuki Uchida, Yoshitaka Toyomasu, Masaki Suzuki, Akiharu Kimura, Norimichi Kogure, Takehiko Yokobori, Tetsuro Ohno, Hiroyuki Kuwano
BACKGROUND AND OBJECTIVES: This multicenter study, which was conducted in northern Kanto, Japan, aimed to assess the efficacy of imatinib mesylate against advanced or recurrent gastrointestinal stromal tumors (GIST). METHODS: The clinicopathological data of 234 GIST patients who were treated at one of the 11 participating hospitals from 2001-2011 were retrospectively reviewed. Imatinib was administered as a first-line therapy in cases involving unresectable disease or postoperative recurrence (41 cases)...
December 2014: Journal of Surgical Oncology
Vinod P Balachandran, Ronald P DeMatteo
The application of imatinib for the treatment of GIST remains a remarkable illustration of the ability and promise of targeted molecular therapy. It is gradually becoming evident that the benefit of imatinib depends on the complex interplay between mutational variations that govern tumor sensitivity to the drug, and biological variables that drive clinical outcome. Evidence is mounting that only a select fraction of patients in the adjuvant setting may benefit from imatinib. Unfortunately, most patients with metastatic disease develop resistance to imatinib, as occurs in other diseases treated with kinase inhibitors...
2014: Advances in Surgery
Evangelos S Photi, Laszlo Igali, Edward C K Cheong, Allan Clark, Michael P N Lewis
BACKGROUND/AIMS: Gastrointestinal stromal tumours are the most frequently occurring sarcoma of the gastrointestinal tract. Current treatment involves complete resection although the surgical or pathological margin required remains unclear. In this study we aimed to examine the risk of local and distant recurrence following laparoscopic resection. METHODS: From a prospective tumour database, we identified and risk stratified primary non-metastatic tumours treated by laparoscopic resection from 2002-2012...
2014: Digestive Surgery
Mario Zovak, Marko Boban, Ljubica Boban, Slaven Cicek, Zrinko Madzar, Borislav Belev, Davor Tomas
OBJECTIVE: Despite significant improvement in survival of gastrointestinal stromal tumors (GIST) due to use of tyrosine kinase inhibitors, surgery still represents the important part of clinical management. The aim of our study was to retrospectively analyze prognosis of GIST depending on the success of surgical treatments and utilization of chemotherapy in transitional country with relatively limited resources. METHODS: cohort of consecutive patients operated for GIST in tertiary medical center, within time frame 1999-2012...
November 2014: International Journal of Surgery
Federico Sista, Valentina Abruzzese, Mario Schietroma, Gianfranco Amicucci
Background. With this study we focus on the etiopathogenesis and on the therapy of the simultaneous occurrence of Gastric gastrointestinal stromal tumor (gGIST) and adenocarcinoma of the stomach in a patient with Billroth II gastric resection (BIIGR). We report the first case of this event and a review of the literature. Methods. A 70-year-old man with a BIIGR, affected by adenocarcinoma of the stomach, was successfully treated with total gastrectomy. The histological examination showed a gastric adenocarcinoma with a synchronous GIST sized 2 cm and S-100, CD117, and CD34 positive...
2013: Case Reports in Surgery
F Duffaud, P Meeus, J B Bachet, P Cassier, T K Huynh, E Boucher, O Bouché, V Moutardier, A le Cesne, B Landi, F Marchal, J O Bay, F Bertucci, J P Spano, E Stoeckle, O Collard, L Chaigneau, N Isambert, V Lebrun-Ly, J Mancini, J Y Blay, S Bonvalot
BACKGROUND: Duodenal GISTs represent 3-5% of all GISTs with limited understanding of patient outcomes. We conducted a retrospective analysis of primary localized duodenal GISTs. METHODS: Patients were identified via a survey from 16 FSG centers (n = 105), and a group of 9 patients enrolled in the BFR14 trial. Data were collected from the original database and patient files, in agreement with French legislation. RESULTS: 114 patients were included, with a median age of 57...
October 2014: European Journal of Surgical Oncology
Edmund K Bartlett, Robert E Roses, Rachel R Kelz, Jeffrey A Drebin, Douglas L Fraker, Giorgos C Karakousis
BACKGROUND: Frequent perioperative morbidity and mortality have been observed in randomized surgical studies for gastric cancer, but specific patient factors associated with morbidity and mortality after total gastrectomy have not been well characterized. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database (2005-2011) for all patients with a gastric neoplasm undergoing total gastrectomy. Univariate and multivariate logistic regression analyses were performed to identify factors associated with an increased risk of morbidity or mortality...
August 2014: Surgery
Magdy A Sorour, Mohamed I Kassem, Abd El-Hamid A Ghazal, Mohamed T El-Riwini, Adel Abu Nasr
BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, accounting for 1-3% of all gastrointestinal malignancies. Throughout the whole length of the gastrointestinal tract, GIST arises most commonly from the stomach followed by small bowel. The clinical presentations of GIST are highly variable according to their site and size. The most frequent symptoms are anemia, weight loss, gastrointestinal bleeding, abdominal pain and massrelated symptoms...
2014: International Journal of Surgery
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