Surgical Treatment of Gastric Gist: Experience from the Esophagus and Stomach Service of a Teaching Hospital

Author(s): Mariana Ottoboni Magalhães, Eumildo de Campos Júnior

Gastrointestinal stromal tumor (GIST) is a rare neoplasm, representing 1–2% of non-epithelial gastrointestinal cancers, with a gastric predominance in 60% of cases. In Brazil, an estimated 3,000 to 5,000 new diagnoses occur annually. Its clinical presentation varies from asymptomatic to nonspecific, hindering early detection. This study retrospectively analyzed cases of gastric GIST treated surgically between 2010 and 2020. Methods An observational, retrospective, and descriptive study was conducted involving 22 patients who underwent surgical resection. Clinical, histological, and surgical data were collected. Results The mean age was 66.18 years, with a predominance of females (68.2%) and individuals of white ethnicity (100%). The most common location was the gastric body (59.1%), with a higher incidence of tumors between 2 and 5 cm (50%). Most CT scans showed localized, non-metastatic lesions. Histologically, 72.7% of the tumors were grade I. The primary immunohistochemical markers were positive for C-Kit (95.5%) and Vimentin (100% of those evaluated), and negative for AE1/AE3 (100%). Laparotomy was utilized in 68.2% of cases, and 95.5% were treated with wedge gastrectomy. Only two patients received adjuvant Imatinib. There were no cases of vascular or angiolymphatic invasion, and 86.4% had free surgical margins. The survival rate ≥ 5 years was 86.4%, with no reports of recurrence in the followed patients. Conclusion Adequate surgical resection of gastric GIST with free margins is associated with high long-term survival and low recurrence rates, demonstrating the effectiveness of surgery in managing this neoplasm.

Gastric GIST, Gastrectomy, Oncological surgery, Mesenchymal neoplasm, Surgical resection, Survival

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