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Clinical outcomes of endoscopic resection for the treatment of intermediate- or high-risk gastric small gastrointestinal stromal tumors: a multicenter retrospective study

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Abstract

Background and aims

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.

Methods

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).

Results

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).

Conclusion

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.

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Funding

Funding was provided by Shanghai Municipal Commission of Science and Technology (Grant Nos. 19411951600, 22S31903800).

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Authors and Affiliations

  1. Zhongshan Hospital, Fudan University, Shanghai, China

    Enpan Xu, Qiang Shi, Zhipeng Qi, Bing Li, Zhong Ren, Shilun Cai, Zhengtao Lv, Zhanghan Chen, Pinghong Zhou & Yunshi Zhong

  2. Tongji Hospital Affiliated to Tongji University, Shanghai Tongji Hospital, Shanghai, China

    Huihui Sun & Shuchang Xu

  3. Shanghai Xuhui Central Hospital, Fudan University, Shanghai, China

    Dongli He

  4. Huashan Hospital, Fudan University, Shanghai, China

    Liang Zhong

  5. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Jiaotong University School of Medicine Xinhua Hospital, Shanghai, China

    Leiming Xu

  6. Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, China

    Xiaobo Li

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  1. Enpan Xu
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Corresponding author

Correspondence to Yunshi Zhong.

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Disclosures

Xu Enpan, Shi Qiang, Qi Zhipeng, Li Bing, Sun Huihui, Ren Zhong, Cai Shilun, He Dongli, Lv Zhengtao, Chen Zhanghan, Zhong Liang, Xu Leiming, Li Xiaobo, Xu Shuchang, Zhou Pinghong, and Zhong Yunshi have no conflicts of interest or financial ties to disclose.

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Xu, E., Shi, Q., Qi, Z. et al. Clinical outcomes of endoscopic resection for the treatment of intermediate- or high-risk gastric small gastrointestinal stromal tumors: a multicenter retrospective study. Surg Endosc 38, 3353–3360 (2024). https://doi.org/10.1007/s00464-024-10753-7

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