Division of Surgical Oncology, Department of Surgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1259, New York, NY 10029, USA.
Division of Surgical Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, East/Shapiro 3, Boston, MA 02215, USA.
Surg Clin North Am. 2025 Feb;105(1):109-124. doi: 10.1016/j.suc.2024.06.009. Epub 2024 Sep 6.
Gastrointestinal stromal tumors (GISTs) are sarcomas that arise from the muscular layer of the gastrointestinal tract. The stomach is the most common location, followed by the small intestine. Surgical resection is the cornerstone of treatment; extensive margins and lymphadenectomy are not routinely required. Commonly utilized resection techniques include wedge gastrectomy, excision and closure of the gastrotomy, and anterior gastrotomy access with internal wedge resection. Tyrosine kinase inhibitors can be utilized in the neoadjuvant setting for cases where a reduction in tumor size would optimize resection, and in the adjuvant setting for high-risk tumors. In select cases, metastasectomy may improve prognosis.
胃肠道间质瘤(GISTs)是一种起源于胃肠道肌层的肉瘤。胃是最常见的发病部位,其次是小肠。手术切除是治疗的基石;广泛的边缘和淋巴结清扫术通常不需要。常用的切除技术包括楔形胃切除术、胃切开术的切除和闭合,以及前胃切开术的内部楔形切除术。酪氨酸激酶抑制剂可在新辅助治疗中用于那些缩小肿瘤体积可优化切除的病例,也可在辅助治疗中用于高危肿瘤。在某些情况下,转移灶切除术可能改善预后。