Aspects diagnostiques et thérapeutiques des tumeurs stromales digestives
Diagnostic and therapeutic aspects of stromal digestive tumours
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract, now defined by the immunohistochemical expression of CD117. We report 17 cases of GIST operated between March 1999 and March 2005 in The Clinique chirurgicale « A » of Rabat (Morocco).
we have retrospectively included GIST confirmed by histopathological and immunohistochemical examination. Demographic, clinical, pathological and treatment data were analysed.
seventeen patients with GIST were operated: 8 men and 9 women. The mean age was 57 years (20–75). Tumours were located in the stomach (n = 12), small intestine (n = 3), oesophagus (n = 1) and rectum (n = 1). Sixteen patients underwent a curative resection adapted to the location, without systematic lymphadenectomy. A patient underwent a hepatic metastasectomy. Resection was not possible in one patient. The mean follow-up was 9 months (1–40). Eight patients were living without recurrence. A patient who had developed liver and peritoneum metastasis was treated by imatinib with good result. A patient operated for oesophagus GIST developed a local recurrence and died 17 months after operation. Seven patients were not followed up, one with liver metastasis.
GIST evolution is hard to predict. Close follow-up of our patients would help us to identify and treat recurrence earlier and determine local patterns of tumour recurrence. Complete and wide surgical resection remains the only efficient treatment in regions where imatinib is not available.
A. BENKABBOU, R. MOHSINE, H.O. EL MALKI, L. IFRINE, A. BELKOUCHI, R. AFIFI, A. Essaid EL FEYDI, S. BALAFREJ
diagnosis, GIST, stromal tumors, surgery