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Il Giornale di Chirurgia

Tumori stromali gastrointestinali: esperienza di un singolo centro

Articolo, 102 - 107
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Abstract
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Introduction: Gastrointestinal stromal tumor (GIST) is the most
frequent mesenchymal neoplasm of the gastrointestinal tract. GIST occur
most frequently in the stomach (60%), jejunum and ileum (30%),
and less frequently in the deuodenum (5%), colon and rectum,esophagus
and appendix. Nowadays GISTs are classified according to Fletcher’s
classification.
Objective: To rewiew the features of our GIST population and to
analyse the outcomes of the patient treated at a single institution and
followed-up prospectively.
Patients and methods: Between August 1997 and March 2009
33 patients with GIST were treated at our institute. Patients were followed
up with medical visit and blood sample tests every six mounth
and with CT scan every 1 year. Data were analized with parametric
and non-parametric tests.
Results: Gender distribution of patient was 16 male (49%) and
17 female (51%); mean age of patient was 62 (37-83). Tumor location
was as follow: stomach 18 (56%), ileum 6 (18%), colon -rectum
3 (9%), esophagus 2 (6%), duodenum 1 (3%), jejune 1(3%), mesentere
1 (3%) e lesser omentum 1 (3%). Tumors were classified according
to Fletcher’s criteria as high risk (4=12.5%), intermediate risk
(10=31%), low risk (18=56%) 30 patients underwent to R0 resection
(94%) while 2 of them R1 resection (6%).
No patients were treated with Imatinib after surgical treatment.
Metastasis or tumor relapse occurred in two patient.
Bigger lesions were statistically located in lower gastrointestinal
tract (ANOVA p=0.045, Mann Whitney p=0.043). A strong correlation
was found between the size of the lesion and the grading of the tumor
(ANOVA p=0.0001). So far upper GISTs seam to be correlated to
a lower grading (Mann Whitney p=0.043)
The survival rate was 90% with a median follow-up of 46
months. Death occurred in 1 patients but the death was not correlated
to disease.
Conclusion: Our results are in according with the literatute in
wich there is no different in sex distribution and the majority of cases
are gastric tumors. The survival rate was 90% with a median followup
of 46 months. Bigger lesions were statistically located in lower gastrointestinal
tract and upper GISTs seam to be correlated to a lower
grading.

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