Lauricella Sara, Valeri Sergio, Mascianà Gianluca, Gallo Ida Francesca, Mazzotta Erica, Pagnoni Chiara, Costanza Saponaro, Falcone Lorenza, Benvenuto Domenico, Caricato Marco, Capolupo Gabriella Teresa
Department of Colorectal Surgery, Campus Bio-Medico University, Rome, Italy.
Department of Surgery for Soft Tissue Sarcoma, Campus Bio-Medico University, Rome, Italy.
J Gastrointest Cancer. 2021 Mar;52(1):57-67. doi: 10.1007/s12029-020-00456-2.
Gastric schwannomas (GSs) are rare mesenchymal neoplasms of the gastrointestinal tract. Diagnosis is often achieved postoperatively, based on pathology reports of retrieved specimens. The aim of the present study is to follow up all patients with gastric schwannoma (Gs) undergoing endoscopic, partial, or more extended surgery and to evaluate the appearance of local or distant recurrence.
A PubMed, Cochrane, and Embase systematic review of the literature has been performed. Original papers, review articles, and case reports published between 1988 and 2019 were considered eligible. All the studies who met the inclusion criteria were analyzed. Statistical analysis of data has been performed using GraphPad Prism 7 software.
Three hundred twenty-eight articles were found, and a total of 102 were included and analyzed in depth. Fifty-three papers reported the follow-up information, ranging from 1 to 417 months across different studies. Among them, 31 patients underwent endoscopic removal of the gastric lesions; 140 patients underwent local surgery, including wedge resection or partial gastrectomy; and 148 patients underwent subtotal or total gastrectomy. The median follow-up was of 27-38-33 months, respectively. No recurrence or distant metastasis was detected in the endoscopy group. Among local surgery group, liver metastasis was reported in one case; in extended surgery group, one patient died for multiple liver metastases.
Local or more extended surgery involved a larger cohort of patients and reported satisfactory long-term results compared with endoscopy group. Surgery in absence of a definite preoperative diagnosis is considered the gold standard treatment for resectable Gs.
胃神经鞘瘤(GSs)是胃肠道罕见的间叶性肿瘤。诊断通常在术后根据所取标本的病理报告做出。本研究的目的是对所有接受内镜、部分或更广泛手术的胃神经鞘瘤(Gs)患者进行随访,并评估局部或远处复发的情况。
对PubMed、Cochrane和Embase数据库进行了系统的文献综述。纳入1988年至2019年间发表的原始论文、综述文章和病例报告。对所有符合纳入标准的研究进行分析。使用GraphPad Prism 7软件对数据进行统计分析。
共检索到328篇文章,其中102篇被纳入并进行深入分析。53篇论文报告了随访信息,不同研究的随访时间从1个月到417个月不等。其中,31例患者接受了内镜下胃病变切除术;140例患者接受了局部手术,包括楔形切除术或部分胃切除术;148例患者接受了次全或全胃切除术。内镜组、局部手术组和广泛手术组的中位随访时间分别为27个月、38个月和33个月。内镜组未检测到复发或远处转移。局部手术组中有1例报告发生肝转移;在广泛手术组中,1例患者因多发肝转移死亡。
与内镜组相比,局部或更广泛手术涉及的患者队列更大,且报告了令人满意的长期结果。对于可切除的Gs,在没有明确术前诊断的情况下进行手术被认为是金标准治疗方法。