Long-term clinical outcome of patients with gastric gastrointestinal stromal tumors.
BACKGROUND
About 10-30% of gastrointestinal stromal tumors prove to be malignant. Nevertheless, the natural history of gastric gastrointestinal stromal tumors has not been fully elucidated.


OBJECTIVE
To determine the long-term clinical outcome of nonresected gastric gastrointestinal stromal tumors.


METHODS
Clinical follow-up of patients with endosonographic characteristics compatible with gastric gastrointestinal stromal tumors was conducted based on Israeli population registry. Lesions with features suggesting malignancy were usually referred to surgery. Follow-up endoscopic ultrasound examinations of nonoperated patients were reviewed.


RESULTS
Seventy-one patients with presumable gastric gastrointestinal stromal tumors were followed. Seventeen patients underwent operation; median tumor size was 43 mm (range 29-70 mm). Within a median of 43 months (range 2-131 months) ten patients died of causes unrelated to gastrointestinal stromal tumor. Forty-four patients with endosonographic diagnosis of gastric gastrointestinal stromal tumors were followed expectantly for a median of 12 years (range 5-15 years). All these patients are alive and without complications associated with gastrointestinal stromal tumor. Follow-up endoscopic ultrasound examinations demonstrated no change in tumor size in six, decrease (by 1-5 mm) in six, and increase (by 2-21 mm) in eight.


CONCLUSIONS
Therapeutic decisions guiding surgical interventions may be based on clinical presentation, comorbidity, and endosonographic characteristics. Nonoperated patients may be safely followed conservatively.
Maor
Yaakov
Y
Department of Gastroenterology and Hepatology, Sheba Medical Center, Tel-Hashomer, Israel. yaakov@sheba.health.gov.il
Avidan
Benjamin
B
Melzer
Ehud
E
Bar-Meir
Simon
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery* / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult