gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Gastrointestinal stromal tumors (GIST) of the stomach – surgical treatment and early postoperative outcome

Meeting Abstract

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  • corresponding author presenting/speaker Frank Meyer - Klinik für Chirurgie, Universitätsklinikum, Magdeburg, Deutschland
  • Lutz Meyer - Chirurgische Klinik, Carl-Thiem-Klinikum, Cottbus
  • Hans Lippert - Klinik für Chirurgie, Universitätsklinikum, Magdeburg
  • Ingo Gastinger - Chirurgische Klinik, Carl-Thiem-Klinikum, Cottbus

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocOP398

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Veröffentlicht: 20. März 2006

© 2006 Meyer et al.
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The aim was, based on a representative number of patients, to investigate frequency, spectrum of localizations, extension & characteristics of tumor growth of gastric GIST with regard to patient characteristics, diagnostic & therapeutic spectrum as well as outcome in daily surgical practice.

Patients & Methods: Out of consecutive 1,199 patients with gastric Ca or GIST enrolled in a prospective multicenter observational study on surgical quality control from 01/01-12/31/2002, a case series of patients with gastric GIST was separately studied. In addition to specific diagnostic criteria, the therapeutic results with regard to operation & resection rate, spectrum of various surgical procedures, perioperative morbidity & hospital mortality were analyzed & compared with results of a 3-year follow-up.

Results: Overall, 55 cases with gastric GIST (55/1,199; 4.6%) were treated (mean age, 62years; sex ratio, m/w=33/22), out of them 29% (n=16) were classified as malignant. The diagnostic profile comprised gastroscopy (87.3%), ultrasound (81.8%) & abdominal CT (67.3%); EUS, only 35.5%. Predominating tumor localization were corpus (n=19; 41.3%) & antrum/pylorus (n=16; 34.8%). Histologic diagnosis was preoperatively only clarified in 47.3% (n=26) of cases (no histology, n=18; 32.7%). All patients underwent a surgical intervention, out of them 94.5% (n=52) were curatively (R0) resected (lymph node metastases, n=5; 5.5%; distant metastases, n=2; 3.6%). Limited tumor resection predominated with 61.8% (n=34) versus 36.4% (n=20) with a radical resection (gastric Ca, 6.6% & 78.9%, resp.), which were combined w/o or w/ lymphadenectomy in 65.5% (n=36) & 34.5% (n=19) of cases, resp. The intervention-associated morbidity was 23.6% (n=13; gastric Ca, 42.0%) whereas the mortality was 0% (gastric Ca, 8.6%). Through the 3-year follow-up (range, 2.5–3.5years), tumor-free survival was 88.7% (n=47/53). 1 patient did not respond & 1 patient declined follow-up investigation (1.8% each). In 4 cases (7.5%), metastases were found: Liver (n=2), liver/spleen & lung (n=1 each). There was no local tumor recurrency (n=0); the overall survival was 98.1% (n=52/53).

Discussion: Gastric GIST represent appr. 5% of the primary gastric tumor lesions. A lymphogenic metastatic tumor growth occurs rarely (5.5%); however, it can not completely excluded, in particular, in advanced tumor growth. The surgical treatment predominated by the limited resection can achieve cure in more than 90% associated with a low morbidity & mortality.