Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Treatment Results of Small Intestinal Gastrointestinal Stromal Tumors Less than 10 cm in Diameter: A Comparison between Laparoscopy and Open Surgery

  • Ihn, Kyong (Department of Surgery, Yonsei University College of Medicine) ;
  • Hyung, Woo Jin (Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Hyoung-Il (Department of Surgery, Yonsei University College of Medicine) ;
  • An, Ji Yeong (Department of Surgery, Yonsei University College of Medicine) ;
  • Kim, Jong Won (Department of Surgery, Yonsei University College of Medicine) ;
  • Cheong, Jae-Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Yoon, Dong Sup (Department of Surgery, Yonsei University College of Medicine) ;
  • Choi, Seung Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Noh, Sung Hoon (Department of Surgery, Yonsei University College of Medicine)
  • Received : 2012.10.12
  • Accepted : 2012.10.18
  • Published : 2012.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: To evaluate the technical feasibility and oncologic safety, we assessed the short-term and long-term outcomes of laparoscopic resection of the small bowel gastrointestinal stromal tumors smaller than 5 cm by comparing those of open surgery by subgroup analysis based on tumor size. Materials and Methods: From November 1993 to January 2011, 41 laparoscopic resections were performed among the 95 patients who underwent resection of small intestine ${\leq}10$ cm in diameter. The clinicopathologic features, perioperative outcomes, recurrences and survival of these patients were reviewed. Results: The postoperative morbidity rates were comparable between the 2 groups. Laparoscopic surgery group showed significantly shorter operative time (P=0.004) and duration of postoperative hospital stay (P<0.001) than open surgery group and it was more apparent in the smaller tumor size group. There were no difference in 5-year survival for the laparoscopic surgery versus open surgery groups (P=0.163), and in 5-year recurrence-free survival (P=0.262). The subgroup analysis by 5 cm in tumor size also shows no remarkable differences in 5-year survival and recurrence-free survival. Conclusions: Laparoscopic resection for small bowel gastrointestinal stromal tumors of size less than 10 cm has favorable short-term postoperative outcomes, while achieving comparable oncologic results compared with open surgery. Thus, laparoscopic approach can be recommended as a treatment modality for patients with small bowel gastrointestinal stromal tumors less than 10 cm in diameter.

Keywords

References

  1. Lewis JJ, Brennan MF. Soft tissue sarcomas. Curr Probl Surg 1996;33:817-872.
  2. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 1998;279:577-580. https://doi.org/10.1126/science.279.5350.577
  3. Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol 2006;23:70-83. https://doi.org/10.1053/j.semdp.2006.09.001
  4. Pandey R, Kochar R. Management of gastrointestinal stromal tumors: looking beyond the knife. An update on the role of adjuvant and neoadjuvant imatinib therapy. J Gastrointest Cancer 2012. [Epub ahead of print]
  5. Wu TJ, Lee LY, Yeh CN, Wu PY, Chao TC, Hwang TL, et al. Surgical treatment and prognostic analysis for gastrointestinal stromal tumors (GISTs) of the small intestine: before the era of imatinib mesylate. BMC Gastroenterol 2006;6:29. https://doi.org/10.1186/1471-230X-6-29
  6. Kim YM, Lim JS, Kim JH, Hyung WJ, Noh SH. Image-based approach for surgical resection of gastric submucosal tumors. J Gastric Cancer 2010;10:188-195. https://doi.org/10.5230/jgc.2010.10.4.188
  7. Miettinen M, Makhlouf H, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol 2006;30:477-489. https://doi.org/10.1097/00000478-200604000-00008
  8. Crosby JA, Catton CN, Davis A, Couture J, O'Sullivan B, Kandel R, et al. Malignant gastrointestinal stromal tumors of the small intestine: a review of 50 cases from a prospective database. Ann Surg Oncol 2001;8:50-59. https://doi.org/10.1007/s10434-001-0050-4
  9. Amin AT, Kono Y, Shiraishi N, Yasuda K, Inomata M, Kitano S. Long-term outcomes of laparoscopic wedge resection for gastrointestinal stromal tumors of the stomach of less than 5 cm in diameter. Surg Laparosc Endosc Percutan Tech 2011;21:260-263. https://doi.org/10.1097/SLE.0b013e318220f1c7
  10. Catena F, Di Battista M, Fusaroli P, Ansaloni L, Di Scioscio V, Santini D, et al. Laparoscopic treatment of gastric GIST: report of 21 cases and literature's review. J Gastrointest Surg 2008;12:561-568. https://doi.org/10.1007/s11605-007-0416-4
  11. Karakousis GC, Singer S, Zheng J, Gonen M, Coit D, DeMatteo RP, et al. Laparoscopic versus open gastric resections for primary gastrointestinal stromal tumors (GISTs): a size-matched comparison. Ann Surg Oncol 2011;18:1599-1605. https://doi.org/10.1245/s10434-010-1517-y
  12. Sexton JA, Pierce RA, Halpin VJ, Eagon JC, Hawkins WG, Linehan DC, et al. Laparoscopic gastric resection for gastrointestinal stromal tumors. Surg Endosc 2008;22:2583-2587. https://doi.org/10.1007/s00464-008-9807-1
  13. Novitsky YW, Kercher KW, Sing RF, Heniford BT. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg 2006;243:738-745. https://doi.org/10.1097/01.sla.0000219739.11758.27
  14. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol 2002;33:459-465. https://doi.org/10.1053/hupa.2002.123545
  15. Demetri GD, von Mehren M, Antonescu CR, DeMatteo RP, Ganjoo KN, Maki RG, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw 2010;8 Suppl 2:S1-41.
  16. Cai W, Wang ZT, Wu L, Zhong J, Zheng MH. Laparoscopically assisted resections of small bowel stromal tumors are safe and effective. J Dig Dis 2011;12:443-447. https://doi.org/10.1111/j.1751-2980.2011.00536.x
  17. Emory TS, Sobin LH, Lukes L, Lee DH, O'Leary TJ. Prognosis of gastrointestinal smooth-muscle (stromal) tumors: dependence on anatomic site. Am J Surg Pathol 1999;23:82-87. https://doi.org/10.1097/00000478-199901000-00009
  18. Dematteo RP, Gold JS, Saran L, Gonen M, Liau KH, Maki RG, et al. Tumor mitotic rate, size, and location independently predict recurrence after resection of primary gastrointestinal stromal tumor (GIST). Cancer 2008;112:608-615. https://doi.org/10.1002/cncr.23199

Cited by

  1. Minimally Invasive Technique Leads to Decreased Morbidity and Mortality in Small Bowel Resections Compared to an Open Technique: An ACS-NSQIP Identified Target for Improvement vol.18, pp.6, 2012, https://doi.org/10.1007/s11605-014-2493-5
  2. Jejunal Cancer with WRN Mutation Identified from Next-Generation Sequencing: A Case Study and Minireview vol.2014, pp.None, 2012, https://doi.org/10.1155/2014/126924
  3. Laparoscopic versus Open Resection of Small Bowel Gastrointestinal Stromal Tumors: Systematic Review and Meta-analysis vol.130, pp.13, 2012, https://doi.org/10.4103/0366-6999.208249
  4. Laparoscopic resection of gastrointestinal stromal tumors: Does laparoscopic surgery provide an adequate oncologic resection? vol.9, pp.9, 2012, https://doi.org/10.4253/wjge.v9.i9.448
  5. Small bowel gastrointestinal stromal tumor: a retrospective study of 32 cases at a single center and review of the literature vol.14, pp.None, 2012, https://doi.org/10.2147/tcrm.s167248
  6. Gastrointestinal stromal tumors: A multidisciplinary challenge vol.24, pp.18, 2012, https://doi.org/10.3748/wjg.v24.i18.1925
  7. Gastrointestinal Stromal Tumors of the Small Intestine: Progress in Diagnosis and Treatment Research vol.12, pp.None, 2012, https://doi.org/10.2147/cmar.s238227
  8. Unusual presentations, management and outcomes of gastric stromal tumors: a single-center case series vol.34, pp.1, 2021, https://doi.org/10.20524/aog.2020.0540