Outcome of surgical resection of localized gastrointestinal stromal tumors: our experience

Background Gastrointestinal stromal tumors (GISTs) constitute the most common non epithelial neoplasm that occur within the gastrointestinal tract with a world wide annual incidence of 8-14/million. They are usually located in the upper gastrointestinal tract particularly in the stomach (60%), in the small bowel (30%), esophagus (5%) and rectum (5%). Gist(s) origin from sporadic mutations within the tyrosine-kinase receptors of the interstitial Cajal cells. The clinical presentation of Gist (s) is quite heterogeneous [1]. The most common associated symptoms are abdominal pain, bleeding, gastroenteric outlet obstruction. Modern cross-sectional imaging studies include TC and/or magnetic resonance imaging in combination with upper endoscopy. Upper endoscopy with ultrasonography (EUS) is an useful tool to pick tissue for diagnosis for cytology (FNA) or trucut biopsy. In addition EUS can show the depth of penetration through the layers of the gastro-enteric wall and origin of these neoplasm . Routinary biopsies increase the risk of tumor spillage or hemorrhage with consequent higher rate of recurrence or disseminated sarcomatosis therefore only selective biopsies are recommended [2]. Complete surgical resection is the only curative therapy of Gist without metastasis. Surgery of large Gists may result technically difficult. However debulking before molecular therapy or reducing the size with neoadjuvant therapy by imatinib can give longer survival and better results [3]. In this study we report our experience on surgical treatment of 16 patients with localized gastrointestinal stromal tumors.