Modern treatment of gastric gastrointestinal stromal tumors

Table 1 Summary of large-series (> 35 cases) of minimally-invasive resections for gastric gastrointestinal stromal tumor

Ref.	Location	MIS/GIST	Proximal tumors n (%)	Size (cm)	Operative time (min)	Complications n (%)	Conversion to open surgery n (%)	LOS (d)	R0 resection rate	Intermediate/high risk GIST n (%)	Recurrence rate n (%)	Median F/U (mo)(range)
Sasaki et al[16]	Japan	451/37	6 (13)	3.2 (1.6-7.4)	100 (30-240)	1 (2)	1 (2)	NR	100	9 (24)	0	74 (1-81)
Sexton et al[14]	Germany	112/61	7 (11)	3.8 (± 1.8)	151.9 (± 67.3)	10 (16.4)	1 (2)	3.9 (± 2.2)	98	15 (25)	3 (5)	15 (0-103)
Wilhelm et al[15]	Germany	93/633	36 (39)	2.6 (0.3-6.5)	90.7	7 (7.5)	6 (6.5)	7.3	100	8 (13)	0	40 (2-99)
Otani et al[13]	Japan	60	36 (60)	3.6 (1.8-15.0)	141/1884	NR	0	7.2	1002	17 (28)	2 (3)	53
Novitsky et al[12]	NC	50	17 (34)	4.4 (± 2.0)	135 (± 56)	4 (8)	0	3.8 (± 1.6)	100	14 (28)	4 (8)	36 (4-84)
Total (for GIST)		271	102 (38)				8 (3)			63 (23)	9 (3)

¹Forty-five laparoscopic operations and 37 confirmed gastrointestinal stromal tumors (GIST);

²no positive margins, but one patient had a laparoscopic resection in the setting of distant metastatic disease;

³ninty-three consecutive patients, including 62 GIST; there was 1 laparascopic-assisted endoscopic resection, 55 laparoscopic wedge resections, and 34 transgastric resections;

⁴the mean operative time was 141 for laparoscopic operations and 188 min for laparoscopy-assisted operations. NC: North Carolina; n: Number of patients in each series; MIS: Minimally invasive operations; Proximal tumors: GIST at gastroesophageal junction or within gastric cardia; Size: Median pathologic tumor size; Complications: Surgical morbidity; LOS: Length of hospital stay; NR: Not reported; R0 resection: Gross and microscopically-negative margins; F/U: Follow-up.

Table 2 Summary of retrospective single-institutional experience with surgical resection of metastatic gastrointestinal stromal tumor after treatment with imatinib mesylate n (%)

Ref.	Number of patients	R0/R1 resections
Sym et al[47]	24	15 (62)
DeMatteo et al[25]	49	39 (80)
Gronchi et al[48]	38	31 (82)
Raut et al[49]	69	57 (83)
Rutkowski et al[51]	24	22 (92)
Bonvalot et al[46]	22	15 (68)
Andtbacka et al[50]	46	22 (48)
Totals	272	201 (74)

R0/R1 resections: Complete gross removal of the gastrointestinal stromal tumor with/without negative microscopic margins.