DIAGNOSIS AND SURGICAL TREATMENT OF GASTROINTESTINAL STROMAL TUMORS OF THE STOMACH USING MINIMALLY INVASIVE TECHNOLOGIES
DOI:
https://doi.org/10.15407/exp-oncology.2025.03.369Keywords:
GIST of the stomach, biopsy, laparoscopic gastric resection, intraoperative fibrogastroduodenoscopy, immunohistochemistryAbstract
Background. Gastrointestinal stromal tumors of the stomach (GIST) are relatively rare, and in 65% of cases, their primary localization is the stomach wall. Considering that the incidence of GIST is 1.2 cases per 10⁵ people per year, not all aspects of the treatment and diagnostic tactics are sufficiently studied. The aim of the study was to examine the possibilities of modern methods of preoperative verification of GIST of the stomach and the effectiveness of their surgical treatment using minimally invasive technologies. Materials and Methods. We analyzed the results of surgical treatment using minimally invasive technologies for 24 GIST patients with tumor localization in the stomach wall treated in the clinic of the Bogomolets National Medical University in 2017—2025. Histological and immunohistochemical analyses of the biopsy and surgical materials were performed. Results. The choice of a method for performing gastric resection depended on the localization and size of the tumor, and the type of its growth. Of 17 (70.8%) patients with the exophytic type of GIST growth, 13 (54.2%) patients had significant difficulties with verification of the tumor in the gastric wall during laparoscopic revision. Conclusion. The results of the study are consistent with international data and emphasize the need for morphological typing and the use of immunohistochemical markers for accurate diagnosis, risk stratification, and selection of further treatment tactics for patients with GIST of the stomach.
References
Blay Jy, Kang yK, Nishida T, von Mehren M. Gastrointestinal stromal tumours. Nat Rev Dis Primers. 2021;7(1):22. https://doi.org/10.1038/s41572-021-00254-5
Alvarez CS, Piazuelo MB, fleitas-Kanonnikoff T, et al. Incidence and survival outcomes of gastrointestinal stromal tumors. JAMA Netw Open. 2024;7(8):e2428828. https://doi.org/10.1001/jamanetworkopen.2024.28828
Moga d, Popentiu A, Popa d. Laparoscopic wedge resection for gastric mesenchymal tumor–small case series. Rom J Mil Med. 2023;126:239-244. https://doi.org/10.55453/rjmm.2023.126.3.1
Doru-Florian-Cornel M, Gabriela V, Anca-Maria F, et al. Understanding gastric GIST: from pathophysiology to personalized treatment. J Clin Med. 2024;13(14):3997. https://doi.org/10.3390/jcm13143997
Kelly CM, Gutierrez Sainz L, Chi P. The management of metastatic GIST: current standard and investigational therapeutics. J Hematol Oncol. 2021;14(1):2. https://doi.org/10.1186/s13045-020-01026-6
Zahidin MSI, Singh J, Azmi SM, et al. Gastrointestinal stromal tumor (GIST) in upper gastrointestinal masquerade anaemia. Cureus. 2024;16(6):e62409. https://doi.org/10.7759/cureus.62409
Shanker dA, Kumar S, Al-Mukhtar A, et al. A Case of gastrointestinal stromal tumour (GIST) in the duodenum in a young adult. Cureus. 2024;16(1):e53331. https://doi.org/10.7759/cureus.53331
Abdalla TSA, Pieper L, Kist M, et al. Gastrointestinal stromal tumors of the upper GI tract: population-based analysis of epidemiology, treatment and outcome based on data from the German Clinical Cancer Registry Group. J Cancer Res Clin Oncol. 2023;149(10):7461-7469. https://doi.org/10.1007/s00432-023-04690-6
Gheorghe G, Bacalbasa N, Ceobanu G, et al. Gastrointestinal stromal tumors — a mini review. J Pers Med. 2021;11(8):694. https://doi.org/10.3390/jpm11080694
Serrano C, Martín-Broto J, Asencio-Pascual JM, et al. 2023 GEIS Guidelines for gastrointestinal stromal tumors. Ther Adv Med Oncol. 2023;15:17588359231192388. https://doi.org/10.1177/17588359231192388
Zalcberg JR. Ripretinib for the treatment of advanced gastrointestinal stromal tumor. Therap Adv Gastroenterol. 2021;14:17562848211008177. https://doi.org/10.1177/17562848211008177
Deprez PH, Moons LMG, O’Toole D, et al. Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2022;54(4):412–429. https://doi.org/10.1055/a-1751-5742
Jakob J, Salameh R, Wichmann d, et al. Needle tract seeding and abdominal recurrence following pre-treatment biopsy of gastrointestinal stromal tumors (GIST): results of a systematic review. BMC Surg. 2022;22(1):202. https://doi.org/10.1186/s12893-022-01648-2
Capuano M, Palomba G, Sorrentino G, etal. Laparoscopicatypicalresectionofsubcardialgastric GISTguidedbyintra-operative endoscopy. A single-center study and a review of the literature. Ann Ital Chir. 2022;11:S2239253X22038750
Ortenzi M, Ghiselli R, Cardinali L, Guerrieri M. Surgical treatment of gastric stromal tumors: laparoscopic versus open approach. Ann Ital Chir. 2017;88:S0003469X17026112. PMId: 28604382
Morales-Conde S, Socas M, Alarcón I, et al. Classification of GIST and other benign gastric tumors based on minimally invasive surgical strategy. Langenbecks Arch Surg. 2023;409(1):3. https://doi.org/10.1007/s00423-023- 03203-w
Yabe N, Takenoya T, Oto I, et al. A case of recurrent gastric GIST who survived for long after laparoscopic resection and imatinib therapy. Cancer Chemother. 2023;50(13):1718-1720. PMId: 38303184
Wu X, Sun Ld, Wang M, et al. Efficacy comparison between laparoscopy and open surgery in the treatment of gastric gastrointestinal stromal tumors larger than 2 cm using multicenter propensity score matching method. Chin J Gastrointest Surg. 2020;23(9):888-895. https://doi.org/10.3760/cma.j.cn.441530-20200616-00366
Teng TZJ, Ishraq f, Chay AfT, Tay KV. Lap-Endo cooperative surgery (LECS) in gastric GIST: updates and future advances. Surg Endosc. 2023;37(3):1672-1682. https://doi.org/10.1007/s00464-022-09691-z
Kolosovych IV. Helicobacter pylori and its role in the pathogenesis of diseases of the digestive system. Fiziol Zh. 2024;70(5):108-120. https://doi.org/10.15407/fz70.05.108
Hallak YO, Karajeh O, Rivas H, Helling K. Incidental gastrointestinal stromal tumors (GIST) during laparoscopic sleeve gastrectomy procedures: a retrospective study. Obes Surg. 2022;32(1):3-7. https://doi.org/10.1007/s11695-021-05770-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Experimental Oncology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
