Editorial
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World J Gastroenterol. Sep 21, 2010; 16(35): 4374-4376
Published online Sep 21, 2010. doi: 10.3748/wjg.v16.i35.4374
Esophagogastric junction gastrointestinal stromal tumor: Resection vs enucleation
Federico Coccolini, Fausto Catena, Luca Ansaloni, Daniel Lazzareschi, Antonio Daniele Pinna
Federico Coccolini, Fausto Catena, Luca Ansaloni, Antonio Daniele Pinna, Unit of General, Emergency and Transplant Surgery, St.Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy
Daniel Lazzareschi, Department of Integrative Biology, University of California, Berkeley, 3060 Valley Life Sciences Building #3140, Berkeley, CA 94720-3140, United States
Author contributions: Coccolini F and Catena F contributed equally to this work, conceived and drafted the manuscript; Ansaloni L and Pinna AD critically revised the manuscript, contributed with important scientific knowledge and gave final approval; Lazzareschi D contributed to the manuscript draft and gave final approval.
Correspondence to: Federico Coccolini, MD, Unit of General, Emergency and Transplant Surgery, St.Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy. fedecocco@iol.it
Telephone: +39-51-6363584 Fax: +39-51-6364745
Received: March 22, 2010
Revised: May 6, 2010
Accepted: May 13, 2010
Published online: September 21, 2010
Abstract

Esophageal gastrointestinal stromal tumors (GISTs) are extremely uncommon, representing approximately 5% of GISTs with the majority of esophageal GISTs occurring at the esophagogastric junction (EGJ). The treatment options available for these GISTs are fairly controversial. Many different options are nowadays at our disposal. From surgery to the target therapies we have the possibility to treat the majority of GISTs, including those which are defined as unresectable. The EGJ GISTs represent a stimulating challenge for the surgeon. The anatomical location increases the possibility of post-operative complications. As the role of negative margins in GIST surgery is still controversial and the efficacy of target therapy has been demonstrated, why not treat EGJ GISTs with enucleation and, where indicated, adjuvant target therapy?

Keywords: Esophagogastric junction; Gastrointestinal stromal tumor; Surgical approach; Resection; Enucleation