The Department of Surgery, McGill University Health Centre, Montréal, Que.
Can J Surg. 2012 Dec;55(6):366-70. doi: 10.1503/cjs.009111.
Emerging data suggest asymptomatic gastrointestinal stromal tumours (GISTs) of the upper gastrointestinal (UGI) tract are not uncommon. We sought to determine their incidence in patients undergoing resection for UGI neoplasms and their impact on surgical and adjuvant treatment.
We accessed a database prospectively listing all patients undergoing resection of non-GIST neoplasms of the stomach and esophagus at a single university centre over a 4.5-year period and reviewed pathology reports for the presence of synchronous GISTs in the UGI tract. We compared patient demographic and tumour characteristics, operative procedures and postoperative outcomes.
In all, 207 patients undergoing gastrectomy or esophagectomy for non- GIST neoplasms were included. We identified 15 synchronous GISTs in the UGI tract of 11 (5.3%) patients (1 preoperatively, 4 intraoperatively and 10 on final pathology), with an average age of 67 years. Most patients were men. Additional resections were required for GISTs identified pre- or intraoperatively. Final pathology revealed completely resected c-kit positive tumours of an average size of 0.5 (range 0.1-4.0) cm with low or very low risk of malignant potential. No patients received adjuvant therapy for the GISTs. After a median follow-up of 11 (range 2-36) months, 5 patients died from their primary cancer, 3 were alive with primary cancer recurrence, and 3 were alive without disease. No patients experienced GIST recurrence.
Incidentally finding a synchronous GIST during resection of UGI neoplasms is not uncommon; it may alter surgical treatment but is unlikely to impact longterm survival.
有新数据表明，上消化道（UGI）的无症状胃肠道间质瘤（GIST）并不少见。我们旨在确定其在上消化道 GIST 患者中接受切除术患者中的发生率及其对手术和辅助治疗的影响。
我们查阅了一个数据库，该数据库前瞻性地列出了在 4.5 年内单一大中心接受胃和食管非 GIST 肿瘤切除术的所有患者，并回顾了 UGI 道中同步 GIST 的病理报告。我们比较了患者的人口统计学和肿瘤特征、手术程序和术后结果。
共有 207 名患者因非 GIST 肿瘤接受胃切除术或食管切除术，我们在 11 名（5.3%）患者的 UGI 道中发现了 15 个同步 GIST（1 个术前，4 个术中，10 个最终病理），平均年龄为 67 岁。大多数患者为男性。对于术前或术中发现的 GIST 需要进行额外的切除术。最终病理显示完全切除的 c-kit 阳性肿瘤，平均大小为 0.5cm（范围为 0.1-4.0cm），恶性潜能低或极低。没有患者因 GIST 接受辅助治疗。在中位数为 11（范围为 2-36）个月的随访后，5 名患者死于原发性癌症，3 名患者死于原发性癌症复发，3 名患者无疾病存活。没有患者发生 GIST 复发。
在上消化道 GIST 肿瘤切除术中偶然发现同步 GIST 并不少见；它可能改变手术治疗，但不太可能影响长期生存。
