Risultati della terapia nei tumori stromali gastrointestinali operabili: nostra esperienza

Surgery is the treatment of choice for localized Gastrointestinal stromal tumors (GIST). Complete resection, tumor size and biological behavior are the most important factors predicting good prognosis. GIST measuring 2 cm and larger should be treated aggressively, while for tumor smaller then 2 cm it is still under evaluation the role of surgery, the efficacy of chemotherapy and the benefits of followup with radiological surveillance. Methods: We present the experience of managing GIST in our Institute. The clinical-pathological parameters, the histopathological behavior and the outcome of patients that underwent to surgery were examined. Results: This is a retrospective study of 9 patients with diagnosis of GIST observed from January 2000 to February 2009. The median age was 62 years (range: 45 to 74 years). The GIST size was in media 42 mm (range: 14 to 70 mm). Complete resection with microscopically tumor-free margins was archivied in all cases (2 with laparoscopic approach, 1 using video-assisted techniques). In one patient that undergo to hepatic primary tumor resection, the biopsy of 15 mm nodule of the stomach wall has showed GIST lesion. No evidence of recurrence was observed during the median follow-up of 55 months. Conclusions: Our patient’cohort showed a variation in the clinical presentation but not in the disease stages. All GISTs have been completely resected and in according to the benign biological behaviour was not required chemotherapy. However, all patients have been enrolled in follow-up program. Results of ongoing trials will established the role of a multidisciplinary approach for GIST therapy