Abstract

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of gastrointestinal tract with different expressions of CD117 (transmembrane KIT receptor tyrosine kinase) from other related tumors, which provides insights into the disease management of GIST. Tyrosine kinase inhibitors reduce the incidence of tumor recurrence and make the tumor resectable. Despite the malignant potential of GISTs, gastric GIST shows a better prognosis versus GISTs at other locations. Contrast-enhanced computed tomography (CECT) is considered the radiological diagnosis of choice because biopsy increases the risk of bleeding and tumor spreading. In addition to surgical resection which remains the mainstay of GIST treatment, active surveillance is also available for gastric tumor with a size <2cm. Currently, given the clinical consensus of an increased response of the tumor to chemotherapy after resection of the advanced lesion, patients with metastasis are also indicated for cytoreductive surgery. Various minimally invasive techniques including endoscopic (endoscopic band ligation, endoscopic muscularis dissection, endoscopic submucosal dissection, endoscopic submucosal tunnelling, endoscopic full-thickness resection), laparoscopic and combined techniques (laparoscopic endoscopic cooperative surgery, combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique) have been developed for surgical resection of tumors. Due to the high recurrence rate even during treatment, patients receive a physical examination and CECT follow-up every 3-5 months for 5 years followed by annual visits.

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