Management of gastrointestinal stromal tumors: A 10-year experience of a single surgical department

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive system. The primary location of GISTs is mainly the gastrointestinal system. Clinical symptoms are nonspecific and mainly depend on the location and size of the tumor. OBJECTIVES: The aim of this study was to conduct a clinical and pathological analysis of 18 cases of GISTs from the medical records of the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, Poland. MATERIAL AND METHODS: The medical records were of women and men at the age of 36-84 years who were treated in the Surgical Clinic. The medical data that was gathered included clinical records, histopathological results and the type of surgical treatment. The study also encompassed the anatomical location and size of the tumor as well as microscopic examination of the tumor. RESULTS: In most cases, GISTs were located in the stomach. The most common symptoms were stomachaches and signs of bleeding into the digestive system. Usually, the tumor presented a diameter of <5 cm and a low grade of malignancy. Out of 18 patients, 16 were treated with laparoscopic resection, whereas in the remaining 2 cases, multiorgan resections were carried out, because the tumor was locally advanced. CONCLUSIONS: It is essential to distinguish stromal tumors from other mesenchymal tumors, since GISTs are among the cancers that have a high risk of malignant progression. The conditions for successful treatment are a properly established histopathological diagnosis, accompanied by immunohistochemical tests for CD117, and a combination of antibodies for a differential diagnosis of other mesenchymal tumors.