Endoscopic treatment for gastric GIST possible for select cases

Endoscopic treatment is feasible in certain patients with gastrointestinal stromal tumors (GISTs), according to a study, however further treatment may be needed if pathology reports indicate intermediate- or high-risk groups.

In this retrospective study, outcomes from 135 gastric subepithelial tumors (SETs) resected by endoscopic procedures and confirmed as GISTs by histopathology were analyzed.

Tumors were in the body (43%), fundus (26.7%), and cardia (17%) and resected by endoscopic submucosal dissection (85.2%), endoscopic mucosal resection (6.7%), submucosal tunneling endoscopic resection (5.9%), and endoscopic full-thickness resection (2.2%). Macroperforation and microperforation occurred in 4.4% and 6.7% of cases, respectively.

The R0 resection rate was 15.6%, however, the complete resection rate by endoscopic view was 90.4%. Of the 90.4%, 54.8% of cases were in the very-low-risk group, 28.1% in the low-risk group, 11.9% in the intermediate-risk group, and 5.2% in the high-risk group.

Of the 118 patients who were monitored for >6 months, recurrence was found in 3.4% during the 36.5 months of follow-up

Reference
Joo MK, Park JJ, Lee YH, et al. Clinical Efficacy and Safety of Endoscopic Treatment of Gastrointestinal Stromal Tumors in the Stomach. Gut Liver. 2023 Feb 15. doi: 10.5009/gnl210454. Epub ahead of print. PMID: 36789572.