Department of Surgery, Medical University of Vienna, Austria; Comprehensive Cancer Center Vienna, Austria.
Int J Surg. 2013;11(9):801-6. doi: 10.1016/j.ijsu.2013.08.016. Epub 2013 Aug 30.
Discovery of the molecular pathogenesis of Gastrointestinal stromal tumors led to the development of targeted therapies, revolutionizing their treatment. However, surgery is still the mainstay of GIST therapy and the only chance for cure.
Here we present a single institutional consecutive case series of 159 GIST-patients.
A total of 159 GIST-patients who underwent resection between 1994 and 2011 were reviewed for clinicopathohistological data, informations on surgical and medical therapy and further follow-up, outcome and survival data.
Laparoscopic (25.2%) and open (71.1%) GIST surgery achieved complete resection rates of 97.5% and 85.2%, whereas 44.4% of incomplete and 6.6% of complete resected patients died from GIST. Compared to open surgery laparoscopy significantly reduced duration of operation (183.4 vs. 130.6 min), length of hospitalization (16.1 vs. 8.3 d) and morbidity (23% vs. 7.5%). Mean survival time was 3.7 ± 2.7 years (R0: 5.1 a and R1: 2.6 a) and the mean overall survival was 4.5 ± 3.8 years.
Complete surgical resection is the primary goal and laparoscopy can be performed safely in a subset of GIST-patients with potential perioperative advantages. Although not proven by the present study the authors assume that multimodal GIST-treatment, as performed in reference-centers, is required for advanced or high risk disease. Our data suggest the potential for minimally invasive GIST resection to achieving comparable oncological outcomes as after open surgery while providing low morbidity rates.
胃肠道间质瘤（GIST）的分子发病机制的发现导致了靶向治疗的发展，彻底改变了其治疗方法。然而，手术仍然是 GIST 治疗的主要方法，也是治愈的唯一机会。
在此，我们报告了一家机构连续 159 例 GIST 患者的病例系列。
回顾性分析了 1994 年至 2011 年间接受切除术的 159 例 GIST 患者的临床病理数据、手术和药物治疗信息以及进一步的随访、结果和生存数据。
腹腔镜（25.2%）和开放性（71.1%）GIST 手术的完全切除率分别为 97.5%和 85.2%，而 44.4%的不完全切除和 6.6%的完全切除患者死于 GIST。与开放性手术相比，腹腔镜手术显著缩短了手术时间（183.4 分钟比 130.6 分钟）、住院时间（16.1 天比 8.3 天）和发病率（23%比 7.5%）。平均生存时间为 3.7±2.7 年（R0：5.1 年和 R1：2.6 年），总生存时间为 4.5±3.8 年。
完全手术切除是主要目标，腹腔镜手术在具有潜在围手术期优势的 GIST 患者亚组中可以安全进行。尽管本研究未证明，但作者假设在参考中心进行的多模式 GIST 治疗是高级或高危疾病所必需的。我们的数据表明，微创 GIST 切除术具有与开放性手术相当的肿瘤学结果的潜力，同时具有较低的发病率。
