Gastrointestinal stromal tumors (GISTs) are rare malignancies but a most common mesenchymal tumor. A multidisciplinary team approach is the optimal care of GIST patients after the remarkable outcomes with the development of molecular-targeted therapy. The objective is to determine the clinic-pathological spectrum and risk category of GIST along with perioperative outcomes. This is a retrospective review of GIST patients between September 2015 – August 2018 at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. Patients’ clinical data, histopathology, immunohistochemistry (IHC) and outcomes were recorded and analyzed. A total of 42 GIST patients were identified with age (19-81 years) and 69% were males. Stomach (35.7%) was the most common site followed by small bowel (23.8%) and duodenum (14.3%). Pain (40.5%) followed by bleeding (30.9%) were major indications. Max tumor dimensions were ranging from 2.8- 30 cm and median mitotic figures were 3 (0-35). Patients were stratified as high, intermediate, low and very low risk (36%, 32%, 32%, and 0% respectively). The majority were managed surgically out of which three cases underwent preoperative angioembolization. CD 117 was positive in 90.5%. Neoadjuvant imatinib given in 2 cases while adjuvant imatinib given in 18 cases. Over a median follow up of 18 months four patients expired while 32 had no issues. Surgical resection is the preferred choice of treatment with or without the molecular targeted drug therapy. Most tumors fall in the high-risk category.
| Published in | Journal of Surgery (Volume 7, Issue 4) |
| DOI | 10.11648/j.js.20190704.14 |
| Page(s) | 104-109 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Gastrointestinal Stromal Tumor (GIST), TUTH, Imatinib
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APA Style
Dhruba Narayan Sah, Ramesh Singh Bhandari, Paleswan Joshi Lakhey, Yogendra Prasad Singh, Pradeep Vaidya, et al. (2019). Experience of Surgical Management of Gastrointestinal Stromal Tumors at a Tertiary Hospital of Nepal. Journal of Surgery, 7(4), 104-109. https://doi.org/10.11648/j.js.20190704.14
ACS Style
Dhruba Narayan Sah; Ramesh Singh Bhandari; Paleswan Joshi Lakhey; Yogendra Prasad Singh; Pradeep Vaidya, et al. Experience of Surgical Management of Gastrointestinal Stromal Tumors at a Tertiary Hospital of Nepal. J. Surg. 2019, 7(4), 104-109. doi: 10.11648/j.js.20190704.14
AMA Style
Dhruba Narayan Sah, Ramesh Singh Bhandari, Paleswan Joshi Lakhey, Yogendra Prasad Singh, Pradeep Vaidya, et al. Experience of Surgical Management of Gastrointestinal Stromal Tumors at a Tertiary Hospital of Nepal. J Surg. 2019;7(4):104-109. doi: 10.11648/j.js.20190704.14
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Download@article{10.11648/j.js.20190704.14,
author = {Dhruba Narayan Sah and Ramesh Singh Bhandari and Paleswan Joshi Lakhey and Yogendra Prasad Singh and Pradeep Vaidya and Prasan Bir Singh Kansakar and Bikal Ghimire and Bishnu Prasad Kandel and Jayant Kumar Sah},
title = {Experience of Surgical Management of Gastrointestinal Stromal Tumors at a Tertiary Hospital of Nepal},
journal = {Journal of Surgery},
volume = {7},
number = {4},
pages = {104-109},
doi = {10.11648/j.js.20190704.14},
url = {https://doi.org/10.11648/j.js.20190704.14},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20190704.14},
abstract = {Gastrointestinal stromal tumors (GISTs) are rare malignancies but a most common mesenchymal tumor. A multidisciplinary team approach is the optimal care of GIST patients after the remarkable outcomes with the development of molecular-targeted therapy. The objective is to determine the clinic-pathological spectrum and risk category of GIST along with perioperative outcomes. This is a retrospective review of GIST patients between September 2015 – August 2018 at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. Patients’ clinical data, histopathology, immunohistochemistry (IHC) and outcomes were recorded and analyzed. A total of 42 GIST patients were identified with age (19-81 years) and 69% were males. Stomach (35.7%) was the most common site followed by small bowel (23.8%) and duodenum (14.3%). Pain (40.5%) followed by bleeding (30.9%) were major indications. Max tumor dimensions were ranging from 2.8- 30 cm and median mitotic figures were 3 (0-35). Patients were stratified as high, intermediate, low and very low risk (36%, 32%, 32%, and 0% respectively). The majority were managed surgically out of which three cases underwent preoperative angioembolization. CD 117 was positive in 90.5%. Neoadjuvant imatinib given in 2 cases while adjuvant imatinib given in 18 cases. Over a median follow up of 18 months four patients expired while 32 had no issues. Surgical resection is the preferred choice of treatment with or without the molecular targeted drug therapy. Most tumors fall in the high-risk category.},
year = {2019}
}
TY - JOUR T1 - Experience of Surgical Management of Gastrointestinal Stromal Tumors at a Tertiary Hospital of Nepal AU - Dhruba Narayan Sah AU - Ramesh Singh Bhandari AU - Paleswan Joshi Lakhey AU - Yogendra Prasad Singh AU - Pradeep Vaidya AU - Prasan Bir Singh Kansakar AU - Bikal Ghimire AU - Bishnu Prasad Kandel AU - Jayant Kumar Sah Y1 - 2019/07/12 PY - 2019 N1 - https://doi.org/10.11648/j.js.20190704.14 DO - 10.11648/j.js.20190704.14 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 104 EP - 109 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20190704.14 AB - Gastrointestinal stromal tumors (GISTs) are rare malignancies but a most common mesenchymal tumor. A multidisciplinary team approach is the optimal care of GIST patients after the remarkable outcomes with the development of molecular-targeted therapy. The objective is to determine the clinic-pathological spectrum and risk category of GIST along with perioperative outcomes. This is a retrospective review of GIST patients between September 2015 – August 2018 at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. Patients’ clinical data, histopathology, immunohistochemistry (IHC) and outcomes were recorded and analyzed. A total of 42 GIST patients were identified with age (19-81 years) and 69% were males. Stomach (35.7%) was the most common site followed by small bowel (23.8%) and duodenum (14.3%). Pain (40.5%) followed by bleeding (30.9%) were major indications. Max tumor dimensions were ranging from 2.8- 30 cm and median mitotic figures were 3 (0-35). Patients were stratified as high, intermediate, low and very low risk (36%, 32%, 32%, and 0% respectively). The majority were managed surgically out of which three cases underwent preoperative angioembolization. CD 117 was positive in 90.5%. Neoadjuvant imatinib given in 2 cases while adjuvant imatinib given in 18 cases. Over a median follow up of 18 months four patients expired while 32 had no issues. Surgical resection is the preferred choice of treatment with or without the molecular targeted drug therapy. Most tumors fall in the high-risk category. VL - 7 IS - 4 ER -
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