| Surgical Management For Rectal Gastrointestinal Stromal Tumor; Single institution experiences. |
| Joo Heung Kim, Chang Hee Kim, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim |
| Department of Surgery, Yonsei University College of Medicine, Seoul, Korea |
| Corresponding Author:
Nam Kyu Kim ,Tel: 02-2228-2105, Fax: 02-313-8289, Email: namkyuk@yuhs.ac |
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Received: October 19, 2012; Accepted: December 27, 2012. |
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| ABSTRACT |
Background: Rectal gastrointestinal tumor is not usually found in rectum and form 0.3% of all rectal malignancy. The aim of this study is to analyze patients who underwent surgical resection for rectal GIST.
Methods: We retrospectively reviewed 10 patients who had been underwent curative operation for rectal GIST from 2006 to 2012. Patients were diagnosed with GIST by Abdomino-pelvic CT scan, MRI, or endoscopic ultrasound. Results were analyzed to identify patients characteristics, method and complication of operation, pathologic feature, hospital day, follow-up including neoadjuvent and adjuvant imatinib mesylate(IM).
Results: Male and female patients were six and four. The mean age was 62 years(range, 49~81 years) The median follow-up period was 24 month(range, 1~68 months). Except routine checkups, most common chief complaints were constipation(30%). All patients underwent R0 resection(trans-anal surgery(n=2), minimally invasive surgery(n=5), open surgery(n=3)). One laparoscopic operation case was converted to laparotomy due to severe tumor adhesion. The mean size of tumor was 5.4cm (range, 1~8cm). The mitotic count shown >5 in 50 high power fields(HPF) was four cases, near total necrosis was two cases and that shown <5 in HPF was three cases. Five(50%) patients received neoadjuvant imatinib therapy following surgery. Adjuvant imatinib therapy was given to four patients based on size and mitotic counts. One local recurrence case was found at 4 year 2month after surgery.
Conclusion: We can conclude that curative resection of rectal GIST with imatinib given to neoadjuvant and adjuvant setting is safe. And there are many various surgical options at rectal GIST management, and another study with more cases and long term follow-up data is indispensable. |
| Keywords:
GIST | rectal GIST | Imatinib | minimally invasive surgery |
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