Gastrointestinal stromal tumor surgery: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
| Line 3: | Line 3: | ||
{{Gastrointestinal stromal tumor}} | {{Gastrointestinal stromal tumor}} | ||
Surgical Therapy | ==Surgical Therapy== | ||
Surgery is typically the initial therapy for the following types of patients: | Surgery is typically the initial therapy for the following types of patients: | ||
*Those with primary GIST who do not have evidence of metastasis | |||
*Those with tumors that are technically resectable if the risks of morbidity are acceptable | |||
In the surgical treatment of GIST, the goal is complete gross resection with an intact pseudocapsule and negative microscopic margins. Because lymph node metastasis is rare with GIST, lymphadenectomy of clinically uninvolved nodes is not necessary. | |||
In the surgical treatment of GIST, the goal is complete gross resection with an intact pseudocapsule and negative microscopic margins. | |||
* Most small GISTs (<5 and especially <2 cm) with a low rate of [[mitosis]] (<5 dividing cells per 50 high-power fields) are [[benign]] and,after surgery, do not require [[adjuvant therapy]]. | * Most small GISTs (<5 and especially <2 cm) with a low rate of [[mitosis]] (<5 dividing cells per 50 high-power fields) are [[benign]] and,after surgery, do not require [[adjuvant therapy]]. | ||
| Line 18: | Line 15: | ||
* Larger GISTs (>5 cm), and especially when the cell division rate is high (>6 [[mitosis|mitoses]]/50 HPF), may disseminate and/or recur. | * Larger GISTs (>5 cm), and especially when the cell division rate is high (>6 [[mitosis|mitoses]]/50 HPF), may disseminate and/or recur. | ||
* Until recently, GISTs were notorious for being resistant to [[chemotherapy]], with a success rate of <5%. Recently, the ''c-kit'' [[tyrosine kinase]] inhibitor [[imatinib]], a drug initially marketed for [[chronic myelogenous leukemia]], was found to be useful in treating GISTs, leading to a 40-70% response rate in metastatic or inoperable cases. | * Until recently, GISTs were notorious for being resistant to [[chemotherapy]], with a success rate of <5%. Recently, the ''c-kit'' [[tyrosine kinase]] inhibitor [[imatinib]], a drug initially marketed for [[chronic myelogenous leukemia]], was found to be useful in treating GISTs, leading to a 40-70% response rate in metastatic or inoperable cases.<ref>{{Cite web | title =Gastrointestinal Stromal Tumors Treatment | ||
| url =http://www.cancer.gov/types/soft-tissue-sarcoma/hp/gist-treatment-pdq#section/_35}}</ref> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 20:20, 31 August 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
|
Gastrointestinal stromal tumor Microchapters |
|
Differentiating Gastrointestinal stromal tumor from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Gastrointestinal stromal tumor surgery On the Web |
|
American Roentgen Ray Society Images of Gastrointestinal stromal tumor surgery |
|
Directions to Hospitals Treating Gastrointestinal stromal tumor |
|
Risk calculators and risk factors for Gastrointestinal stromal tumor surgery |
Surgical Therapy
Surgery is typically the initial therapy for the following types of patients:
- Those with primary GIST who do not have evidence of metastasis
- Those with tumors that are technically resectable if the risks of morbidity are acceptable
In the surgical treatment of GIST, the goal is complete gross resection with an intact pseudocapsule and negative microscopic margins. Because lymph node metastasis is rare with GIST, lymphadenectomy of clinically uninvolved nodes is not necessary.
- Most small GISTs (<5 and especially <2 cm) with a low rate of mitosis (<5 dividing cells per 50 high-power fields) are benign and,after surgery, do not require adjuvant therapy.
- Larger GISTs (>5 cm), and especially when the cell division rate is high (>6 mitoses/50 HPF), may disseminate and/or recur.
- Until recently, GISTs were notorious for being resistant to chemotherapy, with a success rate of <5%. Recently, the c-kit tyrosine kinase inhibitor imatinib, a drug initially marketed for chronic myelogenous leukemia, was found to be useful in treating GISTs, leading to a 40-70% response rate in metastatic or inoperable cases.[1]
References