Zhongshan Hospital, Fudan University, Shanghai, China.
Tongji Hospital Affiliated to Tongji University, Shanghai Tongji Hospital, Shanghai, China.
Surg Endosc. 2024 Jun;38(6):3353-3360. doi: 10.1007/s00464-024-10753-7. Epub 2024 May 2.
Many studies of gastric gastrointestinal stromal tumors (g-GISTs) following endoscopic resection (ER) have typically focused on tumor size, with most tumors at low risk of aggressiveness after risk stratification. There have been few systematic studies on the oncologic outcomes of intermediate- or high-risk g-GISTs after ER.
From January 2014 to January 2020, we retrospectively collected patients considered at intermediate- or high-risk of g-GISTs according to the modified NIH consensus classification system. The primary outcome was overall survival (OS).
Six hundred and seventy nine (679) consecutive patients were diagnosed with g-GISTs and treated by ER between January 2014 and January 2020 in three hospitals in Shanghai, China. 43 patients (20 males and 23 females) were confirmed at intermediate-or high-risk. The mean size of tumors was 2.23 ± 1.01 cm. The median follow-up period was 62.02 ± 15.34 months, with a range of 28 to 105 months. There were no recurrences or metastases, even among patients having R1 resections. The 5-year OS rate was 97.4% (42/43).
ER for intermediate- or high-risk gastric small GISTs is a feasible and safe method, which allows for a wait-and-see approach before determining the necessity for imatinib adjuvant or surgical treatment. This approach to g-GISTs does require that patients undergo close follow-up.
许多内镜下切除（ER）后胃胃肠道间质瘤（g-GIST）的研究通常集中在肿瘤大小上，大多数肿瘤在风险分层后具有低侵袭性风险。对于 ER 后中高危 g-GIST 的肿瘤学结果，很少有系统的研究。
我们回顾性地收集了 2014 年 1 月至 2020 年 1 月期间根据改良 NIH 共识分类系统被认为具有中高危 g-GIST 风险的患者。主要结局是总生存期（OS）。
中国上海三家医院在 2014 年 1 月至 2020 年 1 月期间，共诊断出 679 例连续 g-GIST 患者并接受 ER 治疗，其中 43 例（20 例男性和 23 例女性）被确诊为中高危。肿瘤平均大小为 2.23±1.01cm。中位随访时间为 62.02±15.34 个月，范围为 28 至 105 个月。甚至在接受 R1 切除的患者中，也没有复发或转移。5 年 OS 率为 97.4%（42/43）。
对于中高危胃小 GIST，ER 是一种可行且安全的方法，允许在确定是否需要伊马替尼辅助或手术治疗之前采用等待观察方法。这种 g-GIST 方法确实需要患者进行密切随访。
