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Updated: Jun 6, 2026
Robotic Duodenal Sleeve Resection for Gastrointestinal Stromal Tumor with Rare Exon 8 KIT Mutation Following Neoadjuvant Imatinib
Published on: April 3, 2026
Treatment of gastrointestinal stromal tumors--initial experience
C Lupaşcu1, D Andronic, R Moldovanu
1Department of Surgery, "Gr.T. Popa" University of Medicine and Pharmacy, Iasi, Romania.
Background:
Gastrointestinal Stromal Tumors (GIST) offered the first opportunity of a specific treatment in neoplasms (tyrosine-kinase inhibitors) and also a new perspective of management of other neoplasms.
Methods:
We have prospectively recorded the clinical characteristics, type of surgery, pathologic findings, adjuvant treatment, and recurrence of the patients with confirmed GISTs admitted between January 2004 and December 2008.
Results:
There were 18 patients. Location of the tumor was gastric (44.44%), duodenal (11.11%), jejunal (16.67%), right colon (5.55%) and rectal (22.22%). None of our patients had clinical, imagistic or macroscopic metastases. All the patients had R0 resections, except a patient with local excision and another with R1 anterior resection for rectal GISTs. Postoperatively, 4 patients received Imatinib therapy. The mean follow-up period is 32 months (range 8-58 months); 2 recurrences, both after rectal GISTs. The rest of patients are tumor-free and subjects of prospective follow-up.
Conclusion:
We present the first 5 years experience of a prospective study of GIST started in 2004. The complete resection and the malignant potential according to Fletcher index are the most significant prognostic factors. Imatinib treatment may improve outcome in incomplete resected or high risk GISTs.
Insights
Complete resection and Fletcher index are key prognostic factors for Gastrointestinal Stromal Tumors (GIST). Imatinib therapy may benefit high-risk GIST patients, improving outcomes in this prospective study.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Gastrointestinal Stromal Tumors (GIST) represent a significant area in oncology.
- Tyrosine-kinase inhibitors have revolutionized GIST treatment, offering new management perspectives for neoplasms.
- This study focuses on the early experience with GIST management.
Purpose of the Study:
- To prospectively evaluate clinical characteristics, surgical approaches, pathological findings, adjuvant treatments, and recurrence patterns in GIST patients.
- To identify significant prognostic factors for GIST.
- To assess the role of Imatinib therapy in GIST management.
Main Methods:
- Prospective data collection from January 2004 to December 2008.
- Recording of patient demographics, tumor location, surgical procedures, pathological results, and adjuvant therapies.
- Follow-up to assess recurrence and outcomes, with a mean follow-up of 32 months.
Main Results:
- 18 GIST patients were analyzed, with gastric tumors being most common (44.44%).
- All patients achieved R0 resection except for two cases requiring local excision or R1 resection.
- Two recurrences were observed, both in rectal GIST cases; 4 patients received Imatinib postoperatively.
Conclusions:
- Complete surgical resection and the Fletcher index are crucial prognostic indicators for GIST.
- Imatinib treatment shows potential to improve outcomes for patients with incomplete resections or high-risk GIST.
- This 5-year prospective study provides valuable insights into GIST management and outcomes.