Schmidt Thomas, Ghadimi Markus, Fuchs Hans F, Bruns Christiane J
Klinik für Allgemein‑, Viszeral‑, Tumor und Transplantationschirurgie, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
Chirurg. 2022 Jan;93(1):27-33. doi: 10.1007/s00104-021-01527-1. Epub 2021 Oct 28.
Gastrointestinal stromal tumors (GISTs) are the most frequent potentially malignant mesenchymal tumors of the gastrointestinal tract. The treatment of GISTs has been revolutionized since imatinib and other tyrosine kinase inhibitors were introduced for the treatment of GISTs, which inhibit the tyrosine kinases c‑KIT and platelet-derived growth factor receptor (PDGFR) alpha. Even after the introduction of this targeted treatment GISTs can only be cured by surgical resection. With interdisciplinary multimodal treatment the prognosis of metastasized GIST can now be further improved by surgical resection of the primary tumor and the metastases, potentially leading to a cure. Neoadjuvant therapy can reduce the extent of surgical resection and hereby enable organ preservation and reduce surgical morbidity. To evaluate molecular and clinical predictors and to offer an optimal therapeutic plan, patients with GISTs and certainly patients with advanced GISTs should be evaluated by interdisciplinary sarcoma boards.
胃肠道间质瘤（GISTs）是胃肠道最常见的潜在恶性间充质肿瘤。自从伊马替尼和其他酪氨酸激酶抑制剂被用于治疗GISTs以来，GISTs的治疗发生了革命性变化，这些药物可抑制酪氨酸激酶c-KIT和血小板衍生生长因子受体（PDGFR）α。即使引入了这种靶向治疗，GISTs仍只能通过手术切除治愈。通过多学科综合治疗，现在可以通过手术切除原发性肿瘤和转移灶进一步改善转移性GIST的预后，有可能实现治愈。新辅助治疗可以减少手术切除范围，从而实现器官保留并降低手术并发症发生率。为了评估分子和临床预测指标并提供最佳治疗方案，GIST患者尤其是晚期GIST患者应由多学科肉瘤专家委员会进行评估。
