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Surgical treatment for gastric leiomyosarcoma
1Department of Surgical Oncology National Cancer Center Hospital, Tokyo, Japan. hkatai@gan2.ncc.go.jp
Annales Chirurgiae Et Gynaecologiae
|January 19, 1999
Summary
Wedge resection is the preferred surgical treatment for gastric leiomyosarcoma, especially for tumors larger than 3 cm. This approach offers high survival rates and minimal recurrence, making it ideal for gastric stromal tumors.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Gastric leiomyosarcoma is a rare malignancy with undefined optimal treatment strategies.
- Retrospective analysis of surgical experience is crucial for defining best practices.
Purpose of the Study:
- To define the optimal surgical treatment for gastric leiomyosarcoma.
- To analyze outcomes based on tumor characteristics and surgical procedures.
Main Methods:
- Retrospective review of 103 patients who underwent surgery for gastric leiomyosarcoma between 1972 and 1997.
- Analysis of tumor site, size, ulceration, endoscopic ultrasonography (US) patterns, nodal involvement, surgical procedure, survival rates, and recurrence patterns.
Main Results:
- The upper third of the stomach was the most common site (66 cases).
- Tumors >3 cm, with ulceration, or inhomogeneous US patterns were associated with worse survival.
- Wedge resection (68 patients) yielded a 5-year disease-specific survival of 95.0%, superior to gastrectomy (87.5%).
- No nodal involvement or recurrence was observed.
- Liver and peritoneal metastasis were the dominant recurrence patterns.
Conclusions:
- Surgery is indicated for gastric leiomyosarcoma tumors >3 cm, with rapid growth, inhomogeneous US pattern, or ulceration.
- Wedge resection is the preferred surgical treatment, offering excellent survival and low recurrence rates.
- Close monitoring for liver and peritoneal metastasis is essential post-surgery.