, Volume 55, Issue 7, pp 1815-1817
Date: 29 Apr 2010

Endoscopic Removal of Small Gastrointestinal Stromal Tumors: Can We GIST-ify the Risk?

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GISTs are the most common subepithelial tumor of the stomach with a prevalence of 129 per one million [1]. Nearly 500–600 new cases are diagnosed per year in the United States according to the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute’s (NCI) report in 1995 [2]. More recently, including incidental findings, it is estimated that there are 3,000–6,000 new cases per year in the United States [3]. As more of these lesions are found, a strategy to manage these will need to be developed. A recent AGA technical review suggests observation for GISTs less than 3 cm without high risk features [4].

In this month’s issue of Digestive Diseases and Sciences, Bai et al. present an interesting article on the endoscopic removal of small GIST tumors (<30 mm) [5]. While the authors report a technical success with removal, we should be asking ourselves “should we,” rather than “can we.” To answer this question, we need to have a better understandi ...