Interpretation of guideline for management of gastrointestinal stromal tumour

doi:10.3877/cma.j.issn.2095-3224.2015.01.03

Abstract

Abstract:

As the rare tumor in gastrointestinal(GI)tract, the incidence of GISTs is nearly 1/100000.But GISTs are the most common soft tissue sarcoma in the GI tract.It can arise anywhere along the GI tract, but stomach(60%)and small intestine(30%)are the most common sites, followed by colorectal(5% to 6%)primary site(rectum: 4% and colon: 1%~2%). This review consists of overview, diagnosis, principle of surgery, postoperative recurrence risk assessment, targeted therapy and follow up based on 2014 NCCN guidelines version on soft tissue sarcoma and 2014 ESMO guidelines version on GISTs.We hope that it will offer a little help to gastroenterology, especially to the surgeons.

Key words: Gastrointestinal stromal tumors, Diagnosis, Surgical procedures, operative, Follow-Up studies, Targeted therapy

Lei YU, Xiao-bo LIANG. Interpretation of guideline for management of gastrointestinal stromal tumour[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2015, 04(01): 8-14.

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Figures/Tables 9

References 12

[1]	Nilsson B, Bumming P, Meis-Kindblom JM，et al.Gastrointestinal stromal tumors：the incidence，prevalence clinical course，and prognostication in the pre-imatinibmesylate era-a population based study in western Sweden.Cancer，2005，103：821-829.
[2]	Pappo AS, Janeway KA.Pediatric gastrointestinal stromal tumors.HematolOncolClin North Am，2009，23：15-34.
[3]	Rubin BP, Blanke CD, Demetri GD，et al.Protocol for the examination of specimens from patients with gastrointestinal stromal tumor.Arch Pathol Lab Med，2010，134：165-170.
[4]	Miettinen M, Lasota J．Gastrointestinal stromal tumors：pathology and prognosis at different sites.SeminDiagnPathol，2006，23(2)：70-83.
[5]	Demetri GD, von Mehren M, Antonescu CR，et al.NCCN Task Force report：update on the management of patients with gastrointestinal stromal tumors.J NatlComprCancNetw，2010，2：S1-41；S42-4.
[6]	Ohtani H, Maeda K, Noda E，et al.Meta-analysis of laparoscopic and open surgery for gastric gastrointestinal stromal tumor.Anticancer Res，2013，33：5031-5041.
[7]	Gastrointestinal stromal tumor meta-analysis group(MetaGIST)．Comparison of two doses of imatinib for the treatment of unresectable or metastatic gastrointestinal stromal tumors：a meta-analysis of 1640 patients.J ClinOncol，2010，28：1247-1253.
[8]	Demetri GD, van Oosterom AT, Garrett CR，et al.Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumor after failure of imatinib：arandomised controlled trial.Lancet，2006，368：1329-1338.
[9]	Demetri GD, Reichardt P, Kang YK，et al.On behalf of all GRID study investigators.Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib(GRID)：an international，multicentre，randomised，placebo-controlled，phase 3 trial.Lancet，2013，381：295-302.
[10]	Kang YK, Ryu MH, Yoo C，et al.Resumption of imatinib to control metastatic or unresectable gastrointestinal stromal tumours after failure of imatinib and sunitinib(RIGHT)：a randomised，placebo-controlled，phase 3 trial.Lancet Oncol，2013，14：1175-1182.
[11]	ESMO/European Sarcoma Network Working Group.Gastrointestinal stromal tumours：ESMO Clinical Practice Guidelines for diagnosis，treatment and follow-up.Ann Oncol，2014，3：21-26.
[12]	von Mehren M，Randall RL，National Comprehensive Cancer Network，et al.Soft tissue sarcoma，version2.2014.J NatlComprCancNetw，2014，12(4)：473-483.

肿瘤大小	核分裂像	预后
≤2cm	≤5核分裂像/50HPFs	良性，术后转移率和相关死亡率为0
2cm<直径≤10cm	≤5核分裂像/50HPFs	低度恶性，术后转移率和相关死亡率<4%
≤5cm	>5核分裂像/50HPFs	低度-中度恶性，术后转移率和相关死亡率：12%-15%
>10cm	≤5核分裂像/50HPFs	?
>5cm	>5核分裂像/50HPFs	高度恶性，术后转移率和相关死亡率：49%-86%

肿瘤大小	核分裂像	预后
≤2cm	≤5核分裂像/50HPFs	良性，术后转移率和相关死亡率为0
2cm<直径≤10cm	≤5核分裂像/50HPFs	低度恶性，术后转移率和相关死亡率<4%
≤5cm	>5核分裂像/50HPFs	低度-中度恶性，术后转移率和相关死亡率：12%-15%
>10cm	≤5核分裂像/50HPFs	?
>5cm	>5核分裂像/50HPFs	高度恶性，术后转移率和相关死亡率：49%-86%

肿瘤大小	核分裂像	预后
≤2cm	≤5核分裂像/50HPFs	良性，术后转移率和相关死亡率为0
2cm<直径≤5cm	≤5核分裂像/50HPFs	低度恶性，术后转移率和相关死亡率<4%
≤5cm	>5核分裂像/50HPFs	低度-中度恶性，术后转移率和相关死亡率：25%
5cm<直径≤10cm	≤5核分裂像/50HPFs	?
>10cm	>5核分裂像/50HPFs	高度恶性，术后转移率和相关死亡率：50%-90%

肿瘤大小	核分裂像	预后
≤2cm	≤5核分裂像/50HPFs	良性，术后转移率和相关死亡率为0
2cm<直径≤5cm	≤5核分裂像/50HPFs	低度恶性，术后转移率和相关死亡率<4%
≤5cm	>5核分裂像/50HPFs	低度-中度恶性，术后转移率和相关死亡率：25%
5cm<直径≤10cm	≤5核分裂像/50HPFs	?
>10cm	>5核分裂像/50HPFs	高度恶性，术后转移率和相关死亡率：50%-90%

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