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World J Clin Oncol. Apr 10, 2017; 8(2): 135-144
Published online Apr 10, 2017. doi: 10.5306/wjco.v8.i2.135
How best to manage gastrointestinal stromal tumor
Gandhi Lanke, Jeffrey H Lee
Gandhi Lanke, Jeffrey H Lee, Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Author contributions: Lanke G composed and drafted the paper; Lee JH provided outlines, reviewed and edited the paper.
Conflict-of-interest statement: None of the authors have any potential conflicts (financial, professional, or personal) that are relevant to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jeffrey H Lee, MD, MPH, FASGE, FACG, AGAF, President-Elect (Texas Society for Gastroenterology and Endoscopy), Professor (Department of Gastroenterology, Hepatology, and Nutrition), Director (Advanced Therapeutic Endoscopy Fellowship), Department of Gastroenterology, Hepatology and Nutrition, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, United States. jefflee@mdanderson.org
Telephone: +1-713-7945073 Fax: +1-713-5634408
Received: October 14, 2016
Peer-review started: October 15, 2016
First decision: December 15, 2016
Revised: January 26, 2017
Accepted: February 18, 2017
Article in press: February 20, 2017
Published online: April 10, 2017
Processing time: 175 Days and 1.1 Hours
Abstract

Gastrointestinal stromal tumors (GISTs) are rare but most common nonepithelial tumor of gastrointestinal tract. They are often found incidentally on computed tomography and endoscopic investigations. Increasing knowledge of the pathogenesis of GISTs and the advent of tyrosine kinase inhibitors revolutionized the management of GISTs. The newer advanced endoscopic techniques have challenged the conventional surgery although the true efficacy and safety of endoscopic approach is not clear at this time. This review article focuses on pathogenesis, diagnosis and management of GISTs.

Keywords: Gastrointestinal stromal tumor; Endoscopy; Endoscopic ultrasound-fine-needle aspiration; Tyrosine kinase inhibitor; Imatinib

Core tip: Gastrointestinal stromal tumors (GISTs) are most common mesenchymal tumors in the gastrointestinal tract. The management of GISTs is revolutionized with the advent of tyrosine kinase inhibitors (TKIs) and newer advanced endoscopic techniques. Accurate identification and differentiation of GISTs from other submucosal tumors is achieved with the help of endoscopic ultrasound. The management of small to medium GISTs are feasible by newer advanced endoscopic and/or laparoscopic techniques. Team approach involving endoscopist, pathologist, radiologist, medical oncologist and surgeon is key in optimal management of GISTs. This article focuses on role of TKIs and endoscopist perspective in the management of GISTs.