Gastrointestinální stromální tumor – analýza vlastní sestavy pacientů, přehled literatury


Authors: R. Pohnán;  M. Ryska;  R. Doležel;  I. Veverová 1;  Z. Linke 2
Authors‘ workplace: Chirurgická klinika 2. LF UK a ÚVN Praha, přednosta prof. MUDr. Miroslav Ryska, CSc. ;  Oddělení patologie ÚVN Praha, primář MUDr. Petr Hrabal 1;  Radioterapeuticko-onkologické oddělení FN Motol Praha, primářka MUDr. Jana Prausová 2
Published in: Rozhl. Chir., 2009, roč. 88, č. 11, s. 629-633.
Category: Monothematic special - Original

Overview

Introduction:
Gastrointestinal stromal tumors (GIST) are common mesenchymal gastrointestinal tumors, however, their incidence rate is low. The tumors originate from progenitor cells of interstitial cells of Cajal-gastrointestinal pacemaker cells, and the majority of them express c-Kit, a tyrosin kinase receptor. The aim of this study was to assess the GIST treatment in a group of patients and to compare the outcomes with literature data.

Methods:
The authors performed a retrospecitve analysis of all patients with histologically confirmed GISTs, who were operated in the 2nd Surgical Clinic of the Charles University Medical Faculty (LF UK) in Prague and in the Central Military Hospital Prague (ÚVN Praha), from 2003 to 2008.

Results:
During the five-year period, 13 patients underwent surgery in the Central Military Hospital Prague. The commonest tumor locations were the following: stomach (46%), small intestine (duodenum 23%, jejunum 23%, ileum 8%). R0 resection was performed in 12 subjects (92%). 10 patients (77%) remain in remission, in one patient, the disease is stabilized (8%), and in one patient, the disease progression and generalization has been recorded (8%).

Conclusion:
Surgery is a standard treatment in localized tumors. Following radical resection, the patients benefit from adjacent treatment with tyrosin kinase inhibitors. Specific tyrosin kinase inhibitors have been shown effective in the treatment of metastatic and relapsing disorders. Primary surgical treatment in metastatic diseases remains a paliative option for patients with bleeding and obstruction.

Key words:
gastrointestinal stromal tumor – diagnostics – surgery


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Surgery Orthopaedics Trauma surgery

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