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Kanner D.Yu.

Oncology Hospital No. 62, Moscow, Russia

Kononec P.V.

Oncology Hospital No. 62, Moscow, Russia

Shveikin A.O.

Moscow City Cancer Hospital No. 62 of Moscow Healthcare Department, Moscow, Russia

Shestakov A.L.

B.V. Petrovsky National Research Centre of Surgery, Moscow

Gastrointestinal stromal tumors: surgical treatment and targeted therapy

Authors:

Kanner D.Yu., Kononec P.V., Shveikin A.O., Shestakov A.L.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2017;(12): 28‑35

DOI: 10.17116/hirurgia20171228-35

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GASTROINTESTINAL STROMAL TUMORS: SURGICAL TREATMENT AND TARGETED THERAPY
GASTROINTESTINAL STROMAL TUMORS: SURGICAL TREATMENT AND TARGETED THERAPY

To cite this article:

Kanner DYu, Kononec PV, Shveikin AO, Shestakov AL. Gastrointestinal stromal tumors: surgical treatment and targeted therapy. Pirogov Russian Journal of Surgery. 2017;(12):28‑35. (In Russ.)
https://doi.org/10.17116/hirurgia20171228-35

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Aim. To improve surgical and complex treatment of patients with gastrointestinal stromal tumors (GIST). Material and methods. Our analysis included 97 GIST patients who were at Petrovsky Russian Research Center of Surgery and Moscow City Oncological Hospital №62 from January 2006 to September 2016. Results. Advisability of surgery for GIST patients was confirmed. We have assessed surgical outcomes, defined the indications for adjuvant targeted therapy depending on GIST prognostic risk and additional factors for unfavorable course of disease. Conclusion. It was concluded that surgical treatment is preferred for patients with resectable GISTs. Adjuvant therapy is indicated in patients with high risk of progression if mutations indicating tumor sensitivity to the drugs are revealed. Adjuvant targeted therapy is not indicated in patients with low and very low risk of progression.

Keywords:

gastrointestinal stromal tumor of digestive tract
surgical treatment
adjuvant targeted therapy
imatinib mesilate
malignant potential of tumor
mutational status of tumor

Authors:

Kanner D.Yu.

Oncology Hospital No. 62, Moscow, Russia

Kononec P.V.

Oncology Hospital No. 62, Moscow, Russia

Shveikin A.O.

Moscow City Cancer Hospital No. 62 of Moscow Healthcare Department, Moscow, Russia

Shestakov A.L.

B.V. Petrovsky National Research Centre of Surgery, Moscow

List of references:

  1. Kostka R, Gürlich R, Koldová L. Gastrointestinal Stromal Tumors (GIST): A Single Center Experience. Acta Chirurgica Belgica. 2012;112(1):33-39. https://doi.org/10.1080/00015458.2012.11680792
  2. Judson I, Demetri G. Advances in the treatment of gastrointestinal stromal tumours. Annals of Oncology. 2007;18(suppl 10):20-24. https://doi.org/10.1093/annonc/mdm410
  3. Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the Tyrosine Kinase Inhibitor STI571 in a Patient with a Metastatic Gastrointestinal Stromal Tumor. New England Journal of Medicine. 2001;344(14):1052-1056. https://doi.org/10.1056/nejm200104053441404
  4. Gold JS, van der Zwan SM, Gönen M, Maki RG, Singer S, Brennan MF, et al. Outcome of Metastatic GIST in the Era before Tyrosine Kinase Inhibitors. Annals of Surgical Oncology. 2007;14(10):3027. https://doi.org/10.1245/s10434-006-9297-0
  5. DeMatteo RP, Ballman KV, Antonescu CR, Maki RG, Pisters PW, Demetri GD, et al. Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. The Lancet. 2009;373(9669):1097-1104. https://doi.org/10.1016/s0140-6736(09)60500-6
  6. Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2014;25 (suppl 3):21-26. https://doi.org/10.1093/annonc/mdu255
  7. Fletcher CDM, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Human Pathology. 2002;33(5):459-465. https://doi.org/10.1053/hupa.2002.123545
  8. Hou YY, Lu SH, Zhou Y, Xu JF, Ji Y, Hou J et al. Predictive values of clinical and pathological parameters for malignancy of gastrointestinal stromal tumors. Histol Histopathol. 2009;24(6):737-747. https://doi.org/10.14670/HH-24.737
  9. Wardelmann E, Losen I, Hans V, Neidt I, Speidel N, Bierhoff E, et al. Deletion of Trp-557 and Lys-558 in the juxtamembrane domain of thec-kitprotooncogene is associated with metastatic behavior of gastrointestinal stromal tumors. International Journal of Cancer. 2003;106(6):887-895. https://doi.org/10.1002/ijc.11323
  10. Lasota J, Wozniak A, Kopczynski J, Dansonka-Mieszkowska A, Wasag B, Mitsuhashi T, et al. Loss of heterozygosity on chromosome 22q in gastrointestinal stromal tumors (GISTs): a study on 50 cases. Laboratory Investigation. 2004;85(2):237-247. https://doi.org/10.1038/labinvest.3700218
  11. Schneider-Stock R, Boltze C, Lasota J, Peters B, Corless CL, Ruemmele P, et al. Loss of p16 protein defines high-risk patients with gastrointestinal stromal tumors: a tissue microarray study. Clin Cancer Res. 2005;11(2 Pt 1):638-645.
  12. Schurr P. Microsatellite DNA Alterations of Gastrointestinal Stromal Tumors Are Predictive for Outcome. Clinical Cancer Research. 2006;12(17):5151-5157. https://doi.org/10.1158/1078-0432.ccr-05-2083

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