[Principles of surgical management of stromal tumor]

Gastrointestinal stromal tumors (GIST) have been regarded as rare tumor manifestations of the mesenchymal tissue fraction of the intestinal building principle; however, this tumor is now established as an independent tumor entity owing to independent immunohistochemical and ultrastructural characteristics. In spite of increasing awareness of their biological behavior and their molecular-biological basis, evaluating the grade of many of these tumors remains open, not only on a preoperative but also on a postoperative basis. Thus, how radical the surgical procedure must be is not standardized, as it is in carcinoma surgery. The literature available today is not sufficient to make a valid analytical assumption possible because of small numbers of cases and the heterogeneity of clinical and pathological variables. Therefore, recommendations concerning oncological-surgical radicality have at this time an empirical character. Owing to the rarity of the tumor, this will probably not change in the near future. Adjuvant therapeutical treatment of relevant effectiveness does not exist. Therefore, the radicalness of the operation is organ-specific, tumor-specific and based on tumor-biological criteria.