title: The impact of incidental gastrointestinal stromal tumours on patients undergoing resection of upper gastrointestinal neoplasms.
abstract: BACKGROUND
  Emerging data suggest asymptomatic gastrointestinal stromal tumours (GISTs) of the upper gastrointestinal (UGI) tract are not uncommon. We sought to determine their incidence in patients undergoing resection for UGI neoplasms and their impact on surgical and adjuvant treatment.
  
  
  METHODS
  We accessed a database prospectively listing all patients undergoing resection of non-GIST neoplasms of the stomach and esophagus at a single university centre over a 4.5-year period and reviewed pathology reports for the presence of synchronous GISTs in the UGI tract. We compared patient demographic and tumour characteristics, operative procedures and postoperative outcomes.
  
  
  RESULTS
  In all, 207 patients undergoing gastrectomy or esophagectomy for non- GIST neoplasms were included. We identified 15 synchronous GISTs in the UGI tract of 11 (5.3%) patients (1 preoperatively, 4 intraoperatively and 10 on final pathology), with an average age of 67 years. Most patients were men. Additional resections were required for GISTs identified pre- or intraoperatively. Final pathology revealed completely resected c-kit positive tumours of an average size of 0.5 (range 0.1-4.0) cm with low or very low risk of malignant potential. No patients received adjuvant therapy for the GISTs. After a median follow-up of 11 (range 2-36) months, 5 patients died from their primary cancer, 3 were alive with primary cancer recurrence, and 3 were alive without disease. No patients experienced GIST recurrence.
  
  
  CONCLUSIONS
  Incidentally finding a synchronous GIST during resection of UGI neoplasms is not uncommon; it may alter surgical treatment but is unlikely to impact longterm survival.
authors.affiliation: The Department of Surgery, McGill University Health Centre, Montréal, Que.
authors.forename: Carlos H F
authors.initials: CH
authors.lastname: Chan
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cools-Lartigue
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Marcus
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
authors.forename: Lorenzo E
authors.initials: LE
authors.lastname: Ferri
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D016629:Esophagectomy; D005260:Female; D005743:Gastrectomy; D005770:Gastrointestinal Neoplasms / Q000737:chemistry / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000737:chemistry / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000737:chemistry / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D019009:Proto-Oncogene Proteins c-kit