Management and outcome of gastrointestinal stromal tumors of the duodenum.
BACKGROUND
Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and relatively small subset of GISTs whose optimal surgical procedure has not been well defined. We conducted this study to present the surgical experience in our institution and to analyze the postoperative outcome of duodenal GISTs.


METHODS
A retrospective clinicopathologic analysis was performed for nine duodenal GIST patients who underwent surgery from May 2001 to April 2009. The median follow-up period was 22 months (range: 13-61 months).


RESULTS
A total of nine patients (six males/three females) with a median age of 52 years (range: 45-73 years) were treated. The most common presentation was abdominal pain (45%), and the second portion of duodenum (45%) was most common dominant site. All of the patients underwent limited resection: there were seven wedge resections with primary closures (five open/two laparoscopic) and two segmental resections with end-to-end duodenojejunostomies. The median tumor size was 3.5 cm (range: 1.9-5.5 cm), and the mitotic count was less than fivemitoses/50 high power fields (HPF) in all cases. None patients had neoadjuvant or adjuvant therapy. All of the patients were alive and disease-free.


CONCLUSIONS
We obtained excellent disease-free survival following limited resection with clear margins. Limited resection should be considered a treatment option for duodenal GIST.
Department of Surgery, Soonchunhyang University College of Medicine, Soonchunhyang University Bucheon Hospital, 1174 Jung-dong, Wonmi-gu, Bucheon-si, Gyeonggi-do, South Korea. capcjc@hanmail.net
Jun Chul
JC
Chung
Chong Woo
CW
Chu
Gyu Seok
GS
Cho
Eung Jin
EJ
Shin
Chul Wan
CW
Lim
Hyung Chul
HC
Kim
Ok Pyung
OP
Song
D000368:Aged; D000714:Anastomosis, Surgical; D001707:Biopsy, Needle; D015331:Cohort Studies; D018572:Disease-Free Survival; D004379:Duodenal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007150:Immunohistochemistry; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome