Long-term outcomes of endoscopic resection for small (≤ 4.0 cm) gastric gastrointestinal stromal tumors originating from the muscularis propria layer.

Content Provider	Europe PMC
Author	Zhang, Yu Mao, Xin-Li Zhou, Xian-Bin Yang, Hai Zhu, Lin-Hong Chen, Guang Ye, Li-Ping
Copyright Year	2018
Abstract	AIMTo evaluate the long-term efficacy of endoscopic resection (ER) for small (≤ 4.0 cm) gastric gastrointestinal stromal tumors (GISTs) originating from the muscularis propria layer.METHODSBetween June 2005 and February 2015, we retrospectively analyzed 229 consecutive patients with gastric MP-GISTs who underwent ER with a follow-up at least 36 mo. The main outcome measurements included complete resection rate, complications, and long-term follow-up outcomes.RESULTSER included endoscopic muscularis excavation in 179 cases, endoscopic full-thickness resection in 32 cases, and submucosal tunneling endoscopic resection in 18 cases. The median size of GISTs was 1.90 cm. Of the 229 GISTs, 147 were very low risk, 72 were low risk, 8 were intermediate risk, and 2 were high risk. Short-term outcomes showed the complete resection rate was 96.5%, and 8 patients (3.5%) had complications. Of the 8 patients with complications, only one patient required surgical intervention. Long-term outcomes showed 225 patients were actively followed-up until composition of this manuscript. The remaining 4 patients were lost because of unrelated death. During the follow-up period (median, 57 mo), no residual, recurrent lesions, or distant metastasis were detected in any patients. Binary logistic regression analysis showed tumor size was a risk factor associated with a high mitotic index (≥ 5/50 HPF) of GISTs (P = 0.002).CONCLUSIONER seems to be an effective and safe method for gastric MP-GISTs ≤ 4.0 cm, and, for some intermediate or high risk GISTs, adjuvant therapy and/or additional surgery might be required to reduce the risk of recurrence or metastasis.
ISSN	10079327
Volume Number	24
PubMed Central reference number	PMC6054947
Issue Number	27
PubMed reference number	30038470
Journal	World Journal of Gastroenterology [World J. Gastroenterol]
e-ISSN	22192840
DOI	10.3748/wjg.v24.i27.3030
Language	English
Publisher	Baishideng Publishing Group Inc
Publisher Date	2018-07-01
Access Restriction	Open
Rights License	This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
Subject Keyword	Endoscopic resection Endoscopic full-thickness resection Submucosal tunneling endoscopic resection Gastric gastrointestinal stromal tumors Long-term outcomes
Content Type	Text
Resource Type	Article
Subject	Gastroenterology