Surgical diagnosis and treatment of gastrointestinal stromal tumors: An Analysis of 90 cases

Objective To identify clinical characteristics, diagnosis, treatment and prognosis of gastrointestinal stromal tumor (GIST) and improve the level on standardized diagnosis and treatment of this disease. Methods Clinical and pathological data about 90 patients with GIST in the department of surgical oncology, Chinese PLA General Hospital from September 2009 to September 2014 were retrospectively analyzed. Results The most common primary symptom was abdominal discomfort accounting for 41.1% (37/90), followed by gastrointestinal tract hemorrhage for 20.0% (18/90), abdominal mass for 4.4% (4/90), intestinal obstruction for 3.3% (3/90), 28 cases with no symptoms accounting for 31.1%. The preoperative imageological examinations comprised endoscope, endoscopic ultrasonography, CT, MRI. 90 patients received complete surgical resection. Immunohistochemistry demonstrated that tumor cells were positive for CD117 in 81 cases (90.0%), for CD34 in 82 cases (91.1%), for S-100 in 10 cases (11.1%) and for SMA in 30 cases (33.3%). During a mean follow-up period of 27.4 (range, 1-60) months, 8 patients experienced relapse and metastasis, 3 patients underwent re-operation. Two patients died of tumor progression. Univariate analysis revealed that tumor size (P=0.019) and mitotic rate (P=0.002) were factors affecting prognosis. Conclusion GIST shows typical clinical features. Endoscopy, ultrasound endoscope, CT and MRI examination are helpful for preoperative diagnosis of this disease. The confirmation of GIST also require histopathologic examination and immunohistochemistry. Surgery treatment is the first choice for GIST.