Is There a Place for Thoracoscopic Enucleation of Esophageal Gastrointestinal Stromal Tumors?

Thorac Cardiovasc Surg. 2019 Oct;67(7):585-588. doi: 10.1055/s-0038-1670662. Epub 2018 Sep 28.

Abstract

Background: Esophageal gastrointestinal stromal tumors (E-GISTs) represent less than 1% of all GISTs. The rarity of this lesion precludes the realization of randomized studies, and its treatment remains a matter of debate. We aimed to evaluate the feasibility of enucleation by video-assisted thoracic surgery (VATS) for low- to intermediate-risk E-GIST.

Methods: We performed a retrospective review of patients treated by enucleation through VATS between January 2004 and January 2014 and reviewed the literature.

Results: We included five patients (four men and one woman). Mean age was 53 years (range: 49-79). Three patients were diagnosed because of dysphagia and two others incidentally. The diagnosis was made by immunostaining demonstrating CD117 expression on tumor cells. The mitotic index of all E-GISTs was low (≤ 5 per 50 high-power field). Median postoperative follow-up was 5.5 years, and there was no recurrence.

Conclusion: Thoracoscopic enucleation of E-GIST seems to represent a valuable option as the postoperative morbidity/mortality is low and the oncological outcome is good for low-to-intermediate grade of malignity tumors.This is a retrospective study focused on minimally invasive treatment of E-GIST. We evaluated the feasibility of VATS enucleation of low-to-medium grade of malignity E-GIST.

Publication types

  • Review

MeSH terms

  • Aged
  • Databases, Factual
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / adverse effects
  • Esophagectomy / methods*
  • Feasibility Studies
  • Female
  • Gastrointestinal Stromal Tumors / pathology
  • Gastrointestinal Stromal Tumors / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Retrospective Studies
  • Thoracic Surgery, Video-Assisted* / adverse effects
  • Treatment Outcome