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Updated: May 3, 2026
Robotic Duodenal Sleeve Resection for Gastrointestinal Stromal Tumor with Rare Exon 8 KIT Mutation Following Neoadjuvant Imatinib
Published on: April 3, 2026
Treatment strategy of rectal gastrointestinal stromal tumor (GIST)
Heli Liu1, Zhongshu Yan, Guoqing Liao
1Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
Background:
Rectal gastrointestinal stromal tumor (GIST) is a rare entity. A retrospective analysis of outcomes from a single institution to identify treatment strategies associated with improved outcomes.
Methods:
Records of patients with GIST of the rectum were retrospectively reviewed. Patient and tumor characteristics, treatment details, and outcome were evaluated.
Results:
Compared with the trans-abdominal approach group, the local excision group patients had smaller size and lower location tumors (P < 0.05). Positive resection margin was an important hazard factor for DFS (OR, 7.63; P = 0.015). Among the patients with the tumor size >5 cm, those with preoperative Imatinib therapy had higher rate of a negative resection margin than those without (100% vs. 20%, P = 0.048). Among the patients with intermediate and high-risk tumors, those who received peri-operative Imatinib therapy had longer DFS compared with those without (61.3 ± 6.1 months vs. 20.2 ± 4.4 months, P = 0.030).
Conclusions:
The location of rectal GIST impacts the choice of resection type. Most patients with tumors within 5 cm of the anal verge can be treated with local excision. Positive resection margin is the independent hazard factor for poorer survival. Peri-operative Imatinib therapy is associated with a prolonged DFS in patients with intermediate and high-risk tumors.
