RT Journal Article
T1 Gastrointestinal stromal tumors: A multidisciplinary challenge.
A1 Sanchez-Hidalgo, Juan Manuel
A1 Duran-Martinez, Manuel
A1 Molero-Payan, Rafael
A1 Rufian-Peña, Sebastian
A1 Arjona-Sanchez, Alvaro
A1 Casado-Adam, Angela
A1 Cosano-Alvarez, Antonio
A1 Briceño-Delgado, Javier
K1 Disease management
K1 Endoscopy
K1 Gastroenterology
K1 Gastrointestinal stromal tumors
K1 Nuclear medicine
K1 Oncology
K1 Pathology
K1 Radiology
K1 Surgery
K1 Tyrosine kinase inhibitors
AB Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment. The arise of tyrosine kinase inhibitor has supposed a revolution in GISTs treatment being useful as adjuvant, neoadjuvant or recurrence disease treatment. That is why a multidisciplinary approach to this disease is required. The correct characterization of the tumor at diagnosis (the diagnosis of recurrences and the evaluation of the response to treatment with tyrosine kinase inhibitors) is fundamental for facing these tumors and requires specialized Endoscopist, Radiologists and Nuclear Medicine Physician. Surgery is the only potentially curative treatment for suspected resectable GIST. In the case of high risk GISTs, surgery plus adjuvant Imatinib-Mesylate for 3 years is the standard treatment. Neoadjuvant imatinib-mesylate should be considered to shrink the tumor in case of locally advanced primary or recurrence disease, unresectable or potentially resectable metastasic tumors, and potentially resectable disease in complex anatomic locations to decrease the related morbidity. In the case of Metastatic GIST under Neoadjuvant treatment, when there are complete response, stable disease or limited disease progression, complete cytoreductive surgery could be a therapeutic option if feasible.
PB Baishideng Publishing Group
YR 2018
FD 2018-05-06
LK http://hdl.handle.net/10668/12464
UL http://hdl.handle.net/10668/12464
LA en
NO Sanchez-Hidalgo JM, Duran-Martinez M, Molero-Payan R, Rufian-Peña S, Arjona-Sanchez A, Casado-Adam A, et al. Gastrointestinal stromal tumors: A multidisciplinary challenge. World J Gastroenterol. 2018 May 14;24(18):1925-1941
DS RISalud
RD Apr 11, 2025