Clinicopathological features and management of gastrointestinal stromal tumors complicated with synchronous other alimentary malignant tumor / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the clinicopathologic features, treatment and prognosis of gastrointestinal stromal tumor (GIST) complicated with synchronous other alimentary malignant tumors.</p><p><b>METHODS</b>Clinical data of 525 patients with GIST undergoing surgical treatment from August 2004 to November 2012 in Shanghai Renji Hospital were reviewed retrospectively, among whom 46 patients presented synchronous other alimentary malignancy.</p><p><b>RESULTS</b>GIST and other alimentary malignancy coexisting cases were less likely to be screened out preoperatively (2.2%, 1/46) and associated with elder age (P=0.001), more likely arise from stomach (P=0.000), smaller tumor maximum diameter (P=0.000), and lower mitotic count (P=0.000). According to NIH postoperative risk classification, there were 36 at very low risk, 9 at low risk, and 1 at high risk. Although the risk of GIST recurrence was lower for GIST and other alimentary malignancy coexisting cases, their 5-year survival rate was lower than that of patients with GIST alone (36.1%VS. 82.2%, P=0.000).</p><p><b>CONCLUSIONS</b>GIST patients complicated with synchronous alimentary malignant tumor are usually low or very low risk and has minimal impact on the prognosis. Survival depends primarily on the synchronous alimentary malignant tumors. Therefore, it is reasonable to lay emphasis on the treatment of the alimentary malignant tumor, and perform synchronous resection of GIST if possible.</p>

Clinical analysis of laparoscopic and endoscopic cooperative surgery in the treatment of gastric gastrointestinal stromal tumor: report of 46 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the feasibility and safety of laparoscopic and endoscopic cooperative surgery for treating gastric gastrointestinal stromal tumors(GIST).</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical data of 46 patients with gastric GIST undergoing laparoscopic and endoscopic cooperative surgery between June 2009 and June 2011 at the Renji Hospital of Shanghai Jiaotong University School of Medicine.</p><p><b>RESULTS</b>There were 27 males and 19 females with the mean age of 58.5 years. Thirty-three patients received endoscopy-assisted wedge resection, and 13 cases received laparoscopy-assisted endoscopic resection. All the operations were successful. The mean operative time was (85.5±29.3) min, the mean blood loss was (31.4±12.2) ml, the mean post-operative gastrointestinal functional recovery time was (31.6±14.9) h, and the mean post-operative hospital stay was (5.1±2.9) d. No post-operative complication occurred. NIH risk assessment showed that 34 cases were very low risk and 12 low risk. No recurrence or metastasis was found during the follow-up ranging from 2 to 26 months(median, 12.6 months).</p><p><b>CONCLUSION</b>Laparoscopic and endoscopic cooperative surgery for gastric GIST is both feasible and safe with minimal invasiveness, fast recovery and satisfactory short-term outcomes.</p>