Pancreas preserving surgery for duodenal gastrointestinal stromal tumor removal

Minerva Chir. 2016 Oct;71(5):281-5. Epub 2016 Jun 29.

Abstract

Background: We reported our experience with high-risk, non-metastatic second portion duodenal gastrointestinal stromal tumor (GIST)s in patients who underwent 1-month neoadjuvant cycles with imatinib therapy followed by pancreas-preserving surgery and 12-month of adjuvant chemotherapic regimen including imatinib. This study was conducted to evaluate the short and long-term results.

Methods: The study was conducted between January 2010 and May 2015. Medical charts and operative logbooks of patients were retrospectively reviewed.

Results: Nine patients form the basis of the current analysis. All patients underwent curative resection with pancreas preservation, and all specimens had histologically negative margins. The median follow-up was 35 months. Eight patients were alive, 1 patient died for myocardial infarction at a mean follow-up of 10 months, 1 patient had a recurrence at a mean follow-up of 32 months and no patients developed distant metastases.

Conclusions: We are confident to suggest the use of neoadjuvant and adjuvant Imatinib therapy to those patients affected with D2, high-risk, duodenal GISTs to allow a limited resection.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Duodenal Neoplasms / drug therapy
  • Duodenal Neoplasms / mortality
  • Duodenal Neoplasms / pathology
  • Duodenal Neoplasms / surgery*
  • Duodenum / surgery*
  • Female
  • Follow-Up Studies
  • Gastrointestinal Stromal Tumors / drug therapy
  • Gastrointestinal Stromal Tumors / mortality
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery*
  • Hospitals, University
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Organ Sparing Treatments* / methods
  • Pancreas / surgery
  • Preoperative Care / methods
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Imatinib Mesylate