Management and Survival Analysis of Patients with Duodenal Gastrointestinal Stromal Tumors

Jia-Jun Lu, Ya-Yun Zhu, Yang Gao, Yun-Tao Shi, Xin-Yu Huang and Zhou Yuan

Department of General Surgery, Shanghai Jiao Tong University, China

^*Correspondance to: Zhou Yuan 

 PDF  Full Text DOI: 10.25107/2474-1647.2361

Abstract

Among human gastrointestinal tumors, duodenal Gastrointestinal Stromal Tumors (GISTs) occur infrequently with a lack of lymphatic and submucosal dissemination and a location adjacent to the bile duct and pancreas, leaving the optimal surgical approach underexplored. Options aiming at a R0 resection include Limited Resection (LR) and Pancreaticoduodenectomy (PD). Fifteen patients with duodenal GIST were retrospectively reviewed who underwent surgical resection in our department from January 2008 to December 2012 and were separated into two groups (pancreaticoduodenectomy, PD, n=5 versus limited resection, LR, n=10). A total of 15 patients (seven males/eight females) with a median age of 57 years (range: 33 years to 76 years) were treated. Ten of the patients underwent limited resection: four went for wedge resections with primary closures and six went for segmental resections with end-to-end anastomosis. Patients undergoing PD were more likely to present with a larger tumor (median size: PD, 7.8 cm vs. LR, 5.1 cm; p=0.021) and longer operation time (median time: PD, 274 mins vs. LR, 196 mins; p=0.000). Duodenal GISTs treated by PD had more Mitotic number (median No.: PD, 9.2 vs. LR 4.3; p=0.006) and higher risk compared to LR group. In survival analysis of these patients, OS and DFS rates for the 10 duodenal GIST patients undergoing limited resection were 100% and 93.7% at 1 year and 75% and 67.8 % at 3 years respectively. Additionally, compared with patients undergoing LR, those treated with PD also tended to have a worse OS (p=0.04). And a worse disease-free survival and overall survival was also found associated with tumor size >5 cm and NIH high-risk classification, both with P<0.05. As a result, we recommended LR be performed whenever technically feasible.

Keywords

Cite the article

Lu J-J, Zhu Y-Y, Gao Y, Shi Y-T, Huang X-Y, Yuan Z. Management and Survival Analysis of Patients with Duodenal Gastrointestinal Stromal Tumors. Clin Surg. 2019; 4: 2361.