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Oncological outcomes of large gastrointestinal stromal tumors treated by laparoscopic resection

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Abstract

Background

The resection of large gastric gastrointestinal stromal tumors (GISTs) by laparoscopic has been controversial. Extending from our prior study, the long-term oncological outcome of laparoscopic resection of large (5–8 cm) gastric GISTs was reported.

Methods

From 2002 to 2018, a consecutive 66 patients with gastric GISTs of 5-8 cm were treated at National Taiwan University Hospital. Among them, 30 patients received open surgery, and 36 received laparoscopic surgery. The clinicopathological data, peri-operative and oncological outcomes were compared between groups.

Results

The clinical demographics including sex, age, BMI, tumor locations and ratio of wedge resection were similar between groups. The mean tumor size was 6.0 ± 0.83 cm versus 6.3 ± 1.07 cm (Open vs. Laparoscopic, p = 0.3). The operation time, blood loss, and post-operative complications, were also similar. The mean hospital stay was shorter in the laparoscopic group (8.8 ± 2.5 days) than in the open group (12.0 ± 8.9 days), though not significantly different. The median follow-up time was 108 ± 58 months (97 ± 50 in laparoscopic group; 122 ± 64 in open group). All except three patients remain disease-free. One in the open group and two in the laparoscopic group had recurrence of tumor, and they were stable of disease under Imatinib treatment. Eight patients died in non-GIST causes during follow-up. The 5-year recurrence-free survival were 100% for the open and 94.2% for the laparoscopic group (p = 0.2).

Conclusion

Our data showed that laparoscopic surgery for gastric GIST between 5 and 8 cm was safe and oncologically feasible.

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Authors and Affiliations

  1. Department of Surgery, National Taiwan University Biomedical Park Hospital, Hsinchu, Taiwan

    Sheng-Chieh Lin & Hung-Hsuan Yen

  2. Department of Surgery, National Taiwan University Hospital, No. 7 Chung-Shan South Rd, Zhongzheng, Taipei, 10002, Taiwan

    Po-Chu Lee & I-Rue Lai

  3. Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan

    I-Rue Lai

  4. Department of Surgery, Fu-Jen Catholic University Hospital, New Taipei City, Taiwan

    Sheng-Chieh Lin

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Correspondence to I-Rue Lai.

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Dr. Sheng-Chieh Lin, Dr. Hung-Hsuan Yen, Asst. Prof. Dr. Po-Chu Lee, Prof. Dr. I-Rue Lai have no conflict of interest to disclose.

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Lin, SC., Yen, HH., Lee, PC. et al. Oncological outcomes of large gastrointestinal stromal tumors treated by laparoscopic resection. Surg Endosc 37, 2021–2028 (2023). https://doi.org/10.1007/s00464-022-09693-x

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