Gastrointestinal Stromal Tumors

Abstract

Background: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumors of the gastrointestinal system. Origin, differentiation, classification, and prognosis of these tumors are controversial. Our aim in this study is to enroll our clinical experience about GIST by sharing the current literature information regarding the diagnosis and treatment of it. Patients and Method: Nine patients who was operated and pathologic examination were reported as GIST between 2003–2009 years have been viewed retrospectively. Patients' demographic, clinical, pathological features and treatment methods were evaluated. Results: There were 6 female and 3 male patients with mean age of 65.7±14.2 years. The origins of GIST were stomach in 4 cases (44%), small bowel in 3 (33%) and extra-intestinal in 2 (22%). Two patient's histological diagnosis were done preoperatively. The diagnoses of other patients were done postoperatively. Surgery was performed in emergency conditions in two cases due to complications of tumor. An unresectable patient underwent curative surgery after development on partial remission with imatinib treatment. Four (44%) cases were identified as high risk group, 4 (44%) cases as intermediate, and 1 (11%) case as low risk group according to biological behavior of tumors. Conclusion: Although essential treatment of GIST is surgery, long disease-free survival time and important survival achievements were obtained with the use of tyrosine kinase inhibitors. Ensuring early diagnosis of these tumors and ability of diagnosis with advanced immunohistochemical methods are obstacles to be overcome. Key words: Gastrointestinal Stromal Tumors, Imatinib, Surgical Treatment

Keywords

• Gastrointestinal Stromal Tumors, Imatinib, Surgical Treatment

Gastrointestinal Stromal Tümörler

Öz

Amaç: Gastrointestinal stromal tümör (GİST), gastroinestinal sistemin en sık görülen mezenşimal tümörüdür. Bu tümörlerin kökeni, diferansiyasyonu, sınıflaması ve prognozu tartışmalıdır. Bu çalışmada GİST'le ilgili klinik deneyimlerimizi aktararak, tanı ve tedavisi ile ilgili güncel literatür bilgilerinin paylaşılması amaçlandı. Gereç ve Yöntem: 2003-2009 tarihleri arasında cerrahi girişimde bulunulan ve patolojik tanısı GİST olan 9 olgu retrospektif olarak incelendi. Hastaların demografik, klinik, patolojik özellikleri ve tedavi yöntemleri değerlendirildi. Bulgular: Hastaların 6'sı kadın, 3'ü erkek olup yaş ortalaması 65.7±14.2'idi. Olguların 4'ü (%44) mide, 3'ü (%33) ince barsak ve 2'si (%22) ekstraintestinal kaynaklı idi. İki hastaya preoperatif histolojik tanı kondu. Diğer hastaların tanısı postoperatif konuldu. İki olguya tümörün komplikasyonları nedeniyle acil koşullarda cerrahi girişim uygulandı. Unrezektabl bir olguya imatinib tedavisi sonrası parsiyel remisyon gelişmesi üzerine küratif cerrahi girişim uygulandı. Olgular tümörün biyolojik davranışı yönünden değerlendirildiğinde, 4 hastanın (%44) yüksek risk grubunda, 4 hastanın (%44) orta risk grubunda, bir olgunun ise (%11) düşük risk grubunda olduğu saptandı. Sonuç: GIST'in esas tedavi yöntemi cerrahi olmakla birlikte, tirozin kinaz inhibitörlerinin kullanımı ile hastalıkla iyi yaşam süresi, hastalıksız yaşam süresi ve sağ kalımda önemli başarılar elde edilmiştir. Bu tümörlerin erken tanısının sağlanması ve ileri immünhistokimyasal yöntemlerle tanısının konabilmesi, aşılması gereken engeller olarak durmaktadır. Anahtar kelimeler: Gastrointestinal Stromal Tümör, İmatinib, Cerrahi Tedavi

Anahtar Kelimeler

• Gastrointestinal Stromal Tümör, İmatinib, Cerrahi Tedavi

Kaynakça

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