SciELO - Scientific Electronic Library Online

 
vol.49 issue3Successful conservative treatment of chylothorax following oesophagectomy - a clinical algorithmEndoscopic trans-sphenoidal drainage of petrous apex cholesterol granulomas author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Article

Indicators

Related links

  • On index processCited by Google
  • On index processSimilars in Google

Share


South African Journal of Surgery

On-line version ISSN 2078-5151
Print version ISSN 0038-2361

S. Afr. j. surg. vol.49 n.3 Cape Town Aug. 2011

 

GENERAL SURGERY

 

Gastro-intestinal stromal tumours (GISTs) - the Pretoria experience and a literature review

 

 

R. J. HartleyI; J. H. R. BeckerII; H. van der WaltI; T. LuvhengoI

IM.B. Ch.B., M.Med. (chir.), F.C.S. (s.A.); Department of General Surgery, Faculty of Health Sciences, University of Pretoria
IIM.B. Ch.B., M.Med. (chir.), F.C.S. (s.A.), F.R.C.S. (glasg.), F.R.C.S. (edin.); Department of General Surgery, Faculty of Health Sciences, University of Pretoria

 

 


ABSTRACT

AIM: To analyse the presentation and management of patients with gastro-intestinal stromal tumours (GISTs) at Pretoria hospitals.
DESIGN: A retrospective study was done in which all available clinical records of primary c-KIT positive GISTs were analysed.
SETTING: Secondary and tertiary care institutions in Pretoria, including both private and public hospitals.
SUBJECTS: The population studied included all individuals treated at Pretoria hospitals from 17 July 2000 to 1 April 2009 who had a GIST confirmed with immunohistochemical c-KIT staining. Patients with incomplete or inaccessible clinical records were excluded.
OUTCOME MEASURES: Patient demographics including gender, age and race; presenting symptoms and signs; results of special investigations; and treatment.
RESULTS: Fifty-four cases were identified for inclusion in the study. The age of the subjects ranged from 15 to 83 years. The male-to-female ratio was 1.5:1. The organ most commonly affected was the stomach, and abdominal pain and weight loss were the most common presenting symptoms. Seventy-six per cent of the patients were treated surgically, and 24% received imatinib.
CONCLUSION: GISTs often present late with nonspecific symptoms, and are frequently discovered incidentally. Large tumours tend to be malignant.


 

“Full text available only in PDF format”

 

REFERENCES

1. Gupta P, Tewari M, Shukla HS. Gastrointestinal stromal tumour. Surg Oncol 2008;17(2):129-138.         [ Links ]

2. Blum MG, Bilimoria KY, Wayne JD, et al. Surgical consideration for the management and resection of esophageal gastrointestinal stromal tumours. Ann Thorac Surg 2007;84:1717-1723.         [ Links ]

3. Samelis GF, Ekmektzoglou KA, Zografos GC. Gastrointestinal stromal tumours: Clinical overview, surgery and recent advances in Imatinib mesylate therapy. Eur J Surg Oncol 2007;33:942-950.         [ Links ]

4. Hopkins TG, Marples M, Stark, D. Sunitinib in the management of gastrointestinal stromal tumours. Eur J Surg Oncol 2008;34(8):844-850.         [ Links ]

5. Madeiros F, Corless CL, Duensing A, et al. KIT-negative gastrointestinal stromal tumors. Am J Surg Pathol 2004;28(7):889-894.         [ Links ]

6. Somerhaus N de Saint Aubain, Fletcher CDM. Gastrointestinal stromal tumours: an update. Sarcoma 1998;2:133-141.         [ Links ]

7. Rader AE, Avery A, Wait CL, et al. Fine-needle aspiration biopsy diagnosis of gastrointestinal stromal tumours using morphology, immunocytochemistry, and mutational analysis of c-kit. Cancer 2001;93(4):269-275.         [ Links ]

8. Stamatakos M, Douzinas E, Stefanaki C, et al. Gastrointestinal stromal tumour. World J Surg Oncol 2009;7:61. Published online 1 August 2009. doi: 10.1186/1477-7819-7-61.         [ Links ]

9. DeMatteo R, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumours recurrence patterns and prognostic factors for survival. Ann Surg 2000;231(1):51.         [ Links ]

10. Miettinen M, Majidi M, Lasota J. Pathology and diagnostic criteria of gastrointestinal stromal tumours: a review. Eur J Cancer 2002;38:39-51.         [ Links ]

11. Mukherjee S, Sawyer MAJ, Decker RA. Gastrointestinal stromal tumours. Med-scape Reference. http://emedicine.medscape.com/article/179669-overview (accessed 4 February 2010).         [ Links ]

12. Coffey RJ, Washington MK, Corless CL, et al. Menetrier disease and gastrointestinal stromal tumours: hyperproliferative disorders of the stomach. J Clin Invest 2007;117(1):70-80.         [ Links ]

13. Davis AR, Ahmed W, Purkiss SF. Port site metastasis following diagnostic laparoscopy for a malignant gastro-intestinal stromal tumour. World J Surg Oncol 2008;6:55.         [ Links ]

14. Van Glabbeke M, Verweij J, Casali PG, et al. Initial and late resistance to Imatinib in advanced gastrointestinal stromal tumours are predicted by different prognostic factors: A European Organisation for Research and Treatment of Cancer-Italian Sarcoma Group-Australian Gastrointestinal Trails Group Study. J Clin Oncol 2005;23:5795-5804.         [ Links ]

15. Demetri GD, Von Mehren M, Blake CD, et al. Efficacy and safety of Imatinib mesylate in advanced gastrointestinal stromal tumours. New Engl J Med 2002;347:472-480.         [ Links ]

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License