Clinicopathological study of small bowel gastrointestinal stromal tumor with surgical intervention

Abstract

Objective: Gastrointestinal stromal tumors (GISTs) present with different clinical and immunohistochemical characteristics depending on the anatomic site. The present study clarified the clinicopathological characteristics of small bowel (SB) GISTs, which are relatively infrequent. Patients and Methods: The clinicopathological characteristics of 15 cases of small intestinal GISTs resected at our hospital were reviewed. SBGISTs were divided into duodenal (d) GISTs and jejunal/ ileal (ji) GISTs for the comparison. Results: The tumors included six cases in the duodenum, six in the jejunum, and three in ileum. All patients underwent duodenal wedge resection for dGIST and partial SB resection for jiGIST. The stage was I in seven patients, II in two patients, IIIB in five patients, and IV in one patient. The median postoperative observation period was 67 (11-175) months. Ten patients had no recurrence, two had hepatic and peritoneal recurrence, one had multiple hepatic recurrence, one had peritoneal recurrence, and one had lymph node recurrence. On comparing dGISTs and jiGISTs, recurrence was significantly more frequent in jiGISTs than in dGISTs. Conclusions: In five cases of recurrence, chemotherapy and surgery at the appropriate time seemed effective for achieving a long-term survival. Recurrence was significantly more frequent in jiGISTs than in dGISTs.

Keywords

• small bowel
• gastrointestinal stromal tumors
• diagnosis
• surgical procedure
• chemotherapy