Valutazione di fattori prognostici nel trattamento integrato dei GIST

Marmorale, Cristina and Fiore, F. and Ridolfo, Raffaella and Cavicchi, A. and Fianchini, Aroldo and Feliciotti, E. (2009) Valutazione di fattori prognostici nel trattamento integrato dei GIST. Il giornale di chirurgia, 30 (5 supp). pp. 138-142. ISSN 1971-145X

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Gastrointestinal stromal tumors (GIST) are mesenchymal tumorssupposed to arise from the cells of Cajal for mutations of the tyrosine re-ceptor kinases c-kit or platelet-derived growth factor receptor A. Ima-tinib selectively inhibits the kinase activity. Surgical treatments includ-ing radical resection and local excision remain the main treatment forprimary gastrointestinal stromal tumors (GISTs). Patients with high-grade GISTs have a higher risk of tumor recurrence and a shorter lifeexpectancy the introduction of Imatinib had changed drammaticallythe natural history of that kind of tunors, expecially in non-resectabletumors. AIM: we try to find the relationship between the tumor chara-teristics (size,mitosis, risk group, clinical sign and symptoms) and theoutcome (disease free survival and overall survival). Methods: from2001 to 2007, 20 patients (11 m/9 f) median age 68.9 (range 50-83yrs) underwent surgery for GIST resection, occasional diagnosys wasperformed in 3 patients. 15 were primary GIST, 2 recurrence localizedin ileum. Was performed 9 wedge gastric resections, 1 gastric resection,11 ileal resection. Main tumor size was 7.1 cm +/- 5, tumor necrosiswas found in 2 cases. After a median follow-up of 55.3 months (39.4-71.2) We stratify the patiens in risk group and we observed a statisticrelatrionship between tumor size and mitosis ane DFS and OS. Con-clusion: even in a small group surgical excision of low- and intermedi-ate-grade GIST has an excellent prognosis. Surgery remains the main-stay of treatments, and high-grade tumours carry a significantly worseprognosis. High mitotic rates and size are important poor prognostica-tor.

Item Type: Article
Uncontrolled Keywords: GIST, surgery, risk factors
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 11 Feb 2016 15:36
Last Modified: 11 Feb 2016 15:36

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