Malignant Gastrointestinal Stromal Tumor Diagnosis And Treatments

Objective:Retrospective analysis of clinical experience between moderateand highly risk of recurrence of primary gastrointestinal stromal tumors,investigate gastrointestinal stromal tumor reasonable treatment options andprognostic factorsMethods: Retrospective analysis of clinical between the First AffiliatedHospital of Guangxi Medical University glands Gastrointestinal Surgery,January2008-December2012admitted to all primary gastrointestinal stromaltumor cases, imaging studies, operative and postoperative data pathological dataon all patients with R0resection recurrence risk assessment by improving thestandard line NIH benign and malignant potential of classification, statisticalmoderate degree, a high degree of risk of recurrence in patients with primarygastrointestinal stromal tumor after diagnosis and treatment, surgery,postoperative target Overall survival time:(Gleevec imatinib mesylate, tradename) adjuvant therapy, the follow-up of patients with tumor recurrence andmetastasis after time, recurrence and metastasis after treatment, and the patientagain to the drug imatinib mesylate. Statistical analysis of the group of patientsafter5-year recurrence-free survival (recurrence-free survival, RFS) and overallsurvival (overall survival, OS). Results:Total collected moderate, stromal tumors among patients withprimary gastrointestinal highly recurrence risk of50patients,29males and21females, aged23to79years, with a median age of53years, primary tumor site,including the stomach33Example (antrum6cases,11cases of gastric fundus16cases),17cases of small intestine (jejunum10cases, ileum seven cases),tumor diameter2~25cm, the average diameter of8.21cm, pathologicexamination: the number of cells in mitosis2to75/50HPF, median8/50HPF,immunohistochemical examination: CD117-positive rate of88.9%(40/45),CD34-positive rate of90.9%(40/44), Dog-1-positive rate of81.6%(31/38).RFS1,3,5years after the group of patients were92%(46/50),64%(32/50) and44%(22/50), respectively,1,3,5years after OS98%(49/50),86%(43/50) and60%(30/50), the primary tumor site, tumor size, mitotic count, whetherreceived postoperative imatinib mesylate (imatinib mesylate trade name:Gleevec) adjuvant therapy are prognostic factors.Conclusion:1. Between primary gastrointestinal stromal tumor recurrence aftercomplete resection and transfer risk.2. Between moderate and highly malignant gastrointestinal stromal tumorpatients should be given imatinib mesylate adjuvant therapy, adjuvant therapydose400mg/d,1-year continuous treatment is safe, can prolong RFS.3cases of recurrence or metastasis, such as the line reoperation is oftenpalliative debulking surgery, prolong OS for no significant effect, andreoperation difficult and risky, therefore, between the recurrence ofgastrointestinal stromal tumors cases, the best treatment options should be OKimatinib mesylate treatment to control disease progression.4. The formation of gastrointestinal stromal tumors multidisciplinary treatment team, referring to domestic and inter-professional organizationsannounced GIST GIST treatment guidelines to determine individualizedtreatment programs strive to improve patients receiving imatinib mesylatetargeted therapy compliance, there is medication to testify further improvepatient medication ratio, to improve the efficacy of gastrointestinal stromaltumors has important significance.