CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(08): E950-E956
DOI: 10.1055/a-0619-4803
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Tumor rupture of gastric gastrointestinal stromal tumors during endoscopic resection: a risk factor for peritoneal metastasis?

Shiyi Song
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Wei Ren
2  Department of Geriatrics, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Yi Wang
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Shu Zhang
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Song Zhang
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Fei Liu
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Qiang Cai
3  Digestive Diseases, Emory University, Atlanta, GA, USA
,
Guifang Xu
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Xiaoping Zou
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
,
Lei Wang
1  Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China
› Author Affiliations
Further Information

Publication History

submitted 06 November 2017

accepted after revision 14 March 2018

Publication Date:
01 August 2018 (online)

Abstract

Background and study aims Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract. Up to the present time, complete surgical excision has been the standard treatment for primary GISTs greater than 2 cm. It is well known that tumor rupture during surgery is an independent risk factor for peritoneal metastasis; however, it is not known whether the risk of peritoneal metastasis increases in cases where the tumor is ruptured during endoscopic resection.

Patients and methods A total of 195 patients treated for GIST between January 2014 and December 2016 in our hospital were enrolled in this study. They were divided into two groups according to whether the tumor was ruptured during endoscopic resection. The rate of peritoneal metastasis in patients in the two groups who also suffered perforation was investigated from the follow-up results.

Results Approximately 55.4 % of all patients were female and the average age of the study group was 59.0 ± 10.3 years. Of the 195 patients, the tumors in 27 were ruptured and the remaining 168 patients underwent en bloc resection. There was no statistically significant difference in gender or age between the two groups. The median tumor size (maximum diameter) in all patients was 1.5 cm (0.3 – 5.0 cm): 2.5 cm (0.8 – 5.0 cm) and 1.4 cm (0.3 – 4.0 cm) in the tumor rupture group and en bloc resection group, respectively (P < 0.001). Most of the tumors were located in the gastric fundus. At a median follow-up of 18.7 ± 10.2 months, neither tumor recurrence (liver metastasis, peritoneal metastasis, local recurrence) nor mortality related to GISTs were detected.

Conclusions Tumor rupture during endoscopic resection of gastric GISTs may not be a risk factor for peritoneal metastasis.