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Tunisie Medicale 2006-Oct

[Gastrointestinal stromal tumours: clinical and therapeutic features. A report of 25 cases].

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Heikel Bdioui
Mohamed Jouini
Hatem Bouzaiene
Kais Nouira
Fadhel Fteriche
Rachid Ksantini
Faouzi Chebbi
Montacer J Kacem
Zoubeir Ben Safta

Keywords

Abstract

OBJECTIVE

To evaluate the epidemiological clinical features and herapeutic results of gastrointestinal stromal tumour (GIST).

METHODS

This retrospective study concerned 25 cases of gastrointestinal stromal tumour from January 1993 to December 2002. All patients have been operated and the diagnosis of GIST has been confirmed by histological and immunohistochemical study of pieces of resection or biopsies.

RESULTS

Population include II men and 13 women with a mean age of 64 years. Symptomatology was dominated by abdominal pain (54% of cases) and the digestive haemorrhage (46% of cases). A palpable mass has been found in 29% of cases. The tumour was gastric in 17 cases, small intestinal in 6 cases, colic in 1 case and rectal in 1 case. A double gastric localization and small intestinal was found in 1 case. The mean tumour size was 8 cm (1 to 30 cm). A tumour resection has been achieved in 23 cases (96%), extended to neighbourhood organs in 2 cases. The morbidity was 12.5% and there was no operative mortality. Histologically, tumour was of low grade in 10 cases, high grade in 10 cases and unclassified in 5 cases. With a median follow up of 27 months (2 to 108), we observed 4 cases of loco-regional recurrence. Overall survival at 2 years was 74% for the whole population and 35% for the high grade. Independent prognostic factors recovered were the degree of malignancy (p = 0.01) and the local recurrence (p = 0.01).

CONCLUSIONS

The treatment of the GIST is surgical. lymphadenectomy is superfluous. The new oral chemotherapies that inhibits Tyrosine Kinase seems to be promising.

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