| Abstract [eng] |
Objectives. First, to review the latest issues concerning the management of gastrointestinal stromal tumours (GIST), the pathogenesis of these tumours, clinical manifestation, diagnostic possibilities, prognosis of biologic behaviour, management of treatment. Second, to analyse retrospectively the experience of patients with GIST treated at Vilnius University Hospital "Santariškių klinikos". Methods. The current issues of 2002–2006 on gastrointestinal stromal tumours in the Lithuanian and English languages have been reviewed. A retrospective study of patients with GIST at the Center of Abdominal Surgery of Vilnius University Hospital "Santariškių Klinikos" was done. Results. Gastrointestinal stromal tumours, being the most common nonepithelial mesenchymal tumours of gastrointestinal tract, account for only 1–3% of all gastrointestinal tract malignancies. According to the literature data, the tendency of GIST cases is increasing. Their clinical manifestation varies a lot, besides, there are up to 77% of asymptomatic cases, uncertain localization, all making the diagnosis difficult. Contrast-enhanced CT scan is a standard imaging for patients with suspected GIST. Until the era of Imatinib, surgery had been the only effective treatment. But even after apparently "curative" surgical resections the long-term results were poor, because up to 90% of cases GIST relapse. The liver is the most common site of recurrence (up to 70%). The discovery of Imatinib acting as a molecular target drug is hopeful. However, Imatinib chemotherapy is still at the experimental level, there are no exactly defined indications, duration of treatment, there are difficulties in evaluating tumour response to treatment. So there are unresolved questions in the management of GIST, such as neo-adjuvant or adjuvant therapy, the role of surgery in patients with differential or partial response to Imatinib, and the role of surgery in patients with isolated metastases... |
