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Updated: Feb 12, 2026
Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
Published on: February 19, 2022
Evaluation for therapeutic measures to small gastric stromal tumor: A retrospective study of 90 cases
Qun Zhao1, Yong Li1, Peigang Yang1
1Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei 050011, China.
Abstract:
Surgery and regular follow-up are two main measures for small gastric stromal tumors (sGST) less than 2cm in diameter, while there is no sound evidence to prove which treatment is more beneficial to sGST patients. In this study, we reviewed the clinical and pathological features of patients with sGST receiving surgery and discussed the value of surgical intervention. In all, 90 patients who were diagnosed as sGST(less than 2cm) and accepted surgical treatment were enrolled, correspondently, another 104 patients with GSTs between 2-5cm and 74 patients with GSTs >5cm were collected as Control groups 1 and 2, respectively, and all of them received surgical treatment. Results showed that there were no significant difference among 3 groups in terms of gender, age, clinical features, tumor locations, and mutations of the exon 9 or 11 in C-kit gene, and immunohistochemical results of CD117, CD34, and DOG-1 proteins (P > 0.05). However, we observed growing percentage of medium-/high-risk GSTs and nucleus mitotic counts >5/50 HPF in Control groups (P < 0.05). Patients with sGST were more suitable for minimally invasive procedures than the other 2 groups, with shorter hospital stay (P < 0.05). During the follow-up period (medium 45.4 months), the recurrence rate was also associated with tumor size, which surged from 1.11% in sGST group to 7.69% and 17.56% in Control groups 1 and 2, respectively. In all, we concluded that patients with sGST experienced low proportions of medium-/high-risk tumors; however, they still suffered from potential risk of tumor progression. Due to satisfied surgical outcome, surgical treatment could be suggested for sGST.
Insights
Surgery for small gastric stromal tumors (sGST) under 2cm is effective. While sGSTs have low risk, surgery offers good outcomes and lower recurrence rates compared to larger tumors.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Small gastric stromal tumors (sGST), defined as <2cm, lack definitive treatment evidence compared to surgery.
- Current management strategies for sGST include surgery and regular follow-up, with limited data on optimal approach.
Purpose of the Study:
- To evaluate the clinical and pathological features of sGST patients undergoing surgery.
- To discuss the value and outcomes of surgical intervention for sGST.
- To compare sGST outcomes with larger gastrointestinal stromal tumors (GSTs).
Main Methods:
- Retrospective review of 90 patients with sGST (<2cm) who underwent surgery.
- Comparison with 104 patients with 2-5cm GSTs (Control Group 1) and 74 patients with >5cm GSTs (Control Group 2), all surgically treated.
- Analysis of clinical, pathological, genetic (C-kit exon 9/11 mutations), and immunohistochemical (CD117, CD34, DOG-1) features, alongside risk stratification and recurrence rates.
Main Results:
- No significant differences in demographics, clinical features, tumor location, or genetic/immunohistochemical markers between sGST and larger GST groups.
- Higher incidence of medium-/high-risk GSTs and elevated mitotic counts (>5/50 HPF) in larger tumor groups (P < 0.05).
- sGST patients showed suitability for minimally invasive surgery with shorter hospital stays (P < 0.05) and significantly lower recurrence rates (1.11% vs. 7.69% and 17.56%) over a median follow-up of 45.4 months.
Conclusions:
- sGSTs present a low proportion of medium-/high-risk tumors but retain a potential risk for progression.
- Surgical intervention for sGST yields favorable outcomes, including shorter hospital stays and reduced recurrence rates.
- Surgery is a recommended treatment option for small gastric stromal tumors due to satisfactory outcomes and lower recurrence risk.
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