Long-term outcomes of surgical resection and adjuvant chemotherapy in gastric stromal tumors

Abstract

Introduction: Gastric stromal tumors are a relatively common group of neoplasms. This study is aimed to evaluate treatment outcomes in patients with gastric stromal tumors who underwent surgery and adjuvant treatment at 108 Military Central Hospital

Patients and Methods: This study included 60 patients with gastric stromal tumors who underwent surgery and adjuvant treatment at 108 Military Central Hospital from January 2021 to December 2023. A cross-sectional descriptive study was conducted to assess clinical and paraclinical characteristics, and to evaluate the outcomes of surgical treatment and postoperative adjuvant therapy.

Results: The male/female ratio was 1.4:1, and the average age was 62±11.1 years. Tumor location was mainly in the body of the stomach in 42 out of 60 cases (70%). Laparoscopic surgery was performed in 41 patients (68.4%). Most procedures were wedge gastrectomy. The mean operative time was 67.2 ± 13.3 minutes in the laparoscopic group, 66.8 ± 17.9 minutes in the laparoscopic-assisted group, and 87.2 ± 14.8 minutes in the open surgery group.

The average postoperative hospital stay was 7.5 ± 4 days. Immunohistochemistry results showed that 100% of patients were positive for CD117, S100, and DOG1.KIT. There were no cases of intraoperative complications. Postoperative complications occurred in 6.6%. Of these, one case of leakage, one case of aspiration pneumonia, and one case of anastomotic stenosis. Sixteen patients received postoperative adjuvant treatment with Imatinib 400mg. There were no postoperative deaths. Local recurrence occurred in one patient 1 year after surgery, and one patient developed lymph node and liver metastasis 1.5 years postoperatively. The median disease-free survival time was 36.53 ± 1.01 months.

Conclusions: Laparoscopic surgery for gastric stromal tumors is a favorable method with short surgery times and faster postoperative recovery. Postoperative adjuvant treatment helps reduce the risk of recurrence in high-risk patients.

Keywords: GIST, gastrointestinal stromal tumor, laparoscopic wedge resection

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