title: Surgical treatment of GIST--an institutional experience of a high-volume center.
abstract: BACKGROUND
  Discovery of the molecular pathogenesis of Gastrointestinal stromal tumors led to the development of targeted therapies, revolutionizing their treatment. However, surgery is still the mainstay of GIST therapy and the only chance for cure.
  
  
  OBJECTIVE
  Here we present a single institutional consecutive case series of 159 GIST-patients.
  
  
  METHODS
  A total of 159 GIST-patients who underwent resection between 1994 and 2011 were reviewed for clinicopathohistological data, informations on surgical and medical therapy and further follow-up, outcome and survival data.
  
  
  RESULTS
  Laparoscopic (25.2%) and open (71.1%) GIST surgery achieved complete resection rates of 97.5% and 85.2%, whereas 44.4% of incomplete and 6.6% of complete resected patients died from GIST. Compared to open surgery laparoscopy significantly reduced duration of operation (183.4 vs. 130.6 min), length of hospitalization (16.1 vs. 8.3 d) and morbidity (23% vs. 7.5%). Mean survival time was 3.7 ± 2.7 years (R0: 5.1 a and R1: 2.6 a) and the mean overall survival was 4.5 ± 3.8 years.
  
  
  CONCLUSIONS
  Complete surgical resection is the primary goal and laparoscopy can be performed safely in a subset of GIST-patients with potential perioperative advantages. Although not proven by the present study the authors assume that multimodal GIST-treatment, as performed in reference-centers, is required for advanced or high risk disease. Our data suggest the potential for minimally invasive GIST resection to achieving comparable oncological outcomes as after open surgery while providing low morbidity rates.
authors.affiliation: Department of Surgery, Medical University of Vienna, Austria; Comprehensive Cancer Center Vienna, Austria. Electronic address: katrin.schwameis@meduniwien.ac.at.
authors.forename: Katrin
authors.initials: K
authors.lastname: Schwameis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Fochtmann
authors.forename: Michael
authors.initials: M
authors.lastname: Schwameis
authors.forename: Reza
authors.initials: R
authors.lastname: Asari
authors.forename: Sophie
authors.initials: S
authors.lastname: Schur
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Köstler
authors.forename: Peter
authors.initials: P
authors.lastname: Birner
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ba-Ssalamah
authors.forename: Johannes
authors.initials: J
authors.lastname: Zacherl
authors.forename: Fritz
authors.initials: F
authors.lastname: Wrba
authors.forename: Thomas
authors.initials: T
authors.lastname: Brodowicz
authors.forename: Sebastian Friedrich
authors.initials: SF
authors.lastname: Schoppmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Gist; Minimally invasive surgery; Outcome