Clinical analysis far 26 patients with gastric stromal tumors / 中国癌症杂志

ABSTRACT

Background and purpose. Gastric stromal tumor (GST) is the most common mesenchymal tumor of the gastrointestinal tract and most often arises in the stomach. In the past, surgery was the only effective treatment. The diagnosis and treatment of GST has been revolutionized over the past, since expression of the receptor tyrosine kinase KIT (CD117) was shown to occur on these tumors, the outcome of GST treatment has dramatically been improved. This study focused on the therapeutic experience of GST and analyzed the pathological features and prognostic factors of GST in our center. Methods: All the 26 cases underwent surgical resection and three of them were treated over 6 months with imatinib 400 mg/d. The clinical pathological and follow-up data of 26 patients with GST admitted in our hospital between Jan. 2000 and Dec. 2008 were analyzed retrospectively. Results. All the cases underwent curative resections, including palliative liver resection in 3 patients with liver metastasis. Recurrence occured on 6 patients, including 1 case with low risk group, 1 case with intermediate risk group, 4 cases with high risk group. Tumor size ranged from 2 to 15 cm with the mean of 5.5 cm. The immunohistochemistry results revealed that the positive rates of CD117, CD34 and Vimentin were 92.3%, 80.8% and 96.2% respectively. After operation, three patients accepted imatinib mesylate therapy over 6 months. Two of them were alive, but one had liver metastasis. The follow-up period ranged from 4 to 36 months (median 28 months). Four cases were lost. The 1-, 3-year overall survival rates of 26 cases were 96.2% and 84.6%. Conclusion: Tumor size, location, mitosis and immunohistochemical data are important variables to evaluate GST behavior and prognosis. Surgical resection is the main therapy for GST and targeted therapy will improve the prognosis.