Connective Tissue Oncology Society

2001 CTOS Annual Meeting Posters— Surgery

WHAT DOES THE SURGICAL TREATMENT OF GISTS ? RESEARCH ON 18 PATIENTS WITH GISTS
Takeo Sato¹, Matthias Peiper¹, Thomas Storeichert¹, Annette Fritscher-ravens², Wolfram-Trundo Knoefel¹, Nib Soehendra², Jacob R. Izbicki¹
¹Dept. of General Surgery, University of Hamburg, ²Dept. of Endoscopy, University of Hamburg

OBJECTIVE: The diagnosis and treatment of gastrointestinal stromal tumors (GISTs) is still a field of intensive investigation. Since 1990 we performed exact clinical examination of GISTs of the stomach by which it was treated in ten years in this hospital, we report.

METHODS: This is a retrospective study of 18 patients with GIST that were treated in our hospital from 1990 to 1999. The invented parameters were diagnosis especially endosonography, surgical treatment, pathological diagnosis, TNM classification, and the prognosis.

RESULTS: 9 males and 9females with a mean age of 61 years (34- 83). In most of the cases the symptoms were unspecific. 13 patients suffered from nausea, 3 patients had stomach pain, and GI-bleeding was present in 2 patients. The diagnosis was achieved by endscopy and endsonography, a biopsy was taken in 2 cases. One of them showed a PAPll and other a PAPlll lesion. Liver metastasis was found in 2 patients before the operation. 8 patients received a total gastrectomy with splenectomy, 5 patients a distal gastrectomy, a gastric fundectomy was performed in 2 patients and 3 patients were treated by local resection. The 2 patients showing liver metastasis received a liver excision. The postoperative pathological diagnosis revealed in all of these cases GISTs. The lymph node metastasis was found to one patient. The average of tumor size was 10.3cm. 5 patients were T1, and 13 patients showed T2. 10 patients were G1, 4 patients showed G2, and 4 patients were G3. R0 was performed in 17patients, and 1 patient was received R1. In 2 cases metastasis was found after operation, one of them showed peritonitic carcinomatosis. The death due to GIST‚“ was showed with four cases , and the mean survival term was 52 months(range 4- 98).

CONCLUSION: Our data suggests that in absence of criteria for malignancy the resection of submucosal tumors is not indicated. GISTs causes metastasis only in few cases while metastasis of distant lymph node is very seldom. We perform close controls in these patients, in suspicious cases or if complications occur we performed a resection.