Báo cáo khoa học: Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Management of gastrointestinal stromal tumours in the Imatinib era: a surgeons perspective
Nội dung trích xuất từ tài liệu:
Báo cáo khoa học: "Management of gastrointestinal stromal tumours in the Imatinib era: a surgeons perspective"World Journal of Surgical Oncology BioMed Central Open AccessResearchManagement of gastrointestinal stromal tumours in the Imatinibera: a surgeons perspectiveRavindra S Date*†, Nicholas A Stylianides†, Kishore G Pursnani,Jeremy B Ward and Muntzer M MughalAddress: Department of Gastrointestinal Surgery, Lancashire Teaching Hospital NHS, Foundation Trust, Preston Road, Chorley, Lancashire, PR71PP, UKEmail: Ravindra S Date* - ravidate@hotmail.com; Nicholas A Stylianides - nickstylianides@hotmail.com;Kishore G Pursnani - kish.pursnani@lthtr.nhs.uk; Jeremy B Ward - jeremy.ward@lthtr.nhs.uk; Muntzer M Mughal - muntzer@btinternet.com* Corresponding author †Equal contributorsPublished: 18 July 2008 Received: 9 March 2008 Accepted: 18 July 2008World Journal of Surgical Oncology 2008, 6:77 doi:10.1186/1477-7819-6-77This article is available from: http://www.wjso.com/content/6/1/77© 2008 Date et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Surgical resection has remained the mainstay of treatment of GIST with a 5-year- survival of 28–35%. Tyrosine kinase inhibitor (Imatinib) has revolutionised the treatment of these tumours. The current research is directed towards expanding the role of this drug in the treatment of GIST. We present our experience of managing GIST in this institute. Methods: This is a case note study of patients identified from a prospectively kept database from January 2000 to August 2007. Results: 16 patients were diagnosed with GIST. The median age was 66 years (range 46 to 82) and the male to female ratio was 9:7. Eleven patients underwent surgery, 9 of which had R0 resection (2 laparoscopic, 1 converted to open), one had an open biopsy and one had a debulking procedure. 3 patients were inoperable and 2 were found to be unfit for surgery. Five patients received Imatinib (2 postoperatively). The risk assessment based on morphological criteria showed that 4 patients had low, 4 had intermediate and 8 had high malignant potential. The median follow up was for 12 months (range 3–72); 2 patients died of unrelated causes at 6 and 9 months after diagnosis. Conclusion: Most GISTs can be managed effectively using existing protocols. However currently there is no evidence based guidance available on the management of GIST in the following situations-role of debulking surgery, the follow up of benign tumours not requiring surgical resection and role of laparoscopic surgery. Further research is needed to answer these questions. simple resectional surgery remained the mainstay of treat-BackgroundGastrointestinal stromal tumours (GIST) represent a sub- ment with 5-year-survival rates of 28–35%[2,3] for R0group of mesenchymal tumours, which were traditionally resections. Introduction of Imatinib mesylate (tyrosineknown as leiomyomas or leiomyosarcomas and have tra- kinase inhibitor) for the treatment of GIST at the begin-ditionally been treated by surgery. The results of a simple ning of this century has improved outcomes in metastaticsurgical resection with clear margins were comparable to and unresectable tumours. Demetri et al have shown thatthose of a radical resection [1]. Therefore until recently Imatinib is useful in the treatment of unresectable or met- Page 1 of 4 (page number not for citation purposes)World Journal of Surgical Oncology 2008, 6:77 ...