Results of the Management of Gastrointestinal Stromal Tumors (GIST): About 6 Cases at the Vichy Hospital Center (France)

Abstract

The aim of our study was to analyze the results of surgical management of gastrointestinal stromal tumors (GIST) at the Vichy Hospital Center. Methodology : Between 2010 and 2020, the data of 6 patients operated at the Vichy Hospital Center for GIST were analyzed. The parameters studied were: age, sex, antecedents, discovery circumstances, imagery, surgical procedure, anatomopathological data, the follow-up and the morbidity-mortality. Results : There were 5 men and one woman with an average age of 72.16 years [58 - 80 years]. The average time of evolution was 8 months (0 - 14 months). The diagnosis was fortuitous in 2 cases. Atypical abdominal pain was the main symptom in 3 cases. One case was received in a clinical picture of peritoneal irritation syndrome. Echo-endoscopy with biopsy specimen histology made it possible to make the diagnosis in 5 cases and the surgical specimen in 1 case. The fusiform type was the predominant histological form. The stomach was the most common location. The average size of GISTs was 7.3 × 4 cm with a positive C Kit in all patients. Neoadjuvant chemotherapy was performed o n one patient. Surgery was curative and was done laparoscopically on 4 patients. Adjuvant chemotherapy based on Imatinib at a rate of 400 mg/d in 3 patients was initiated. One patient presented a fistula of the esophagus-jejunal anastomosis on D6 post operation controlled by a drainage and an antibiotic therapy. Mortality was zero. During the surgery, all of the patients were follow ed up with surgeon, oncologist. Conclusion : GISTs are the most common mesenchymal tumors of the digestive tract with a preferential gastric location. Laparoscopic surgery, with advances in molecular biology and the introduction of targeted therapy ha s improved the management of these tumors in terms of morbidity and mortality.