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Review
. 2016 Jan;19(1):3-14.
doi: 10.1007/s10120-015-0526-8. Epub 2015 Aug 15.

The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines

Affiliations
Review

The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines

Toshirou Nishida et al. Gastric Cancer. 2016 Jan.

Abstract

Although gastrointestinal stromal tumors (GISTs) are a rare type of cancer, they are the commonest sarcoma in the gastrointestinal tract. Molecularly targeted therapy, such as imatinib therapy, has revolutionized the treatment of advanced GIST and facilitates scientific research on GIST. Nevertheless, surgery remains a mainstay of treatment to obtain a permanent cure for GIST even in the era of targeted therapy. Many GIST guidelines have been published to guide the diagnosis and treatment of the disease. We review current versions of GIST guidelines published by the National Comprehensive Cancer Network, by the European Society for Medical Oncology, and in Japan. All clinical practice guidelines for GIST include recommendations based on evidence as well as on expert consensus. Most of the content is very similar, as represented by the following examples: GIST is a heterogeneous disease that may have mutations in KIT, PDGFRA, HRAS, NRAS, BRAF, NF1, or the succinate dehydrogenase complex, and these subsets of tumors have several distinctive features. Although there are some minor differences among the guidelines--for example, in the dose of imatinib recommended for exon 9-mutated GIST or the efficacy of antigen retrieval via immunohistochemistry--their common objectives regarding diagnosis and treatment are not only to improve the diagnosis of GIST and the prognosis of patients but also to control medical costs. This review describes the current standard diagnosis, treatment, and follow-up of GISTs based on the recommendations of several guidelines and expert consensus VSports手机版. .

Keywords: Consensus based; Evidence-based; Gastrointestinal stromal tumor; Guidelines. V体育安卓版.

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Conflict of interest statement

Conflict of interest

T. Nishida has received funding for basic research from Novartis and Bayer, and honoraria for speeches from Bayer and Pfizer. J. -Y. Blay has received research support and honoraria from Novartis, Pfizer, and Bayer. Y. -K. Kang has received grants for research and honoraria for speeches from Novartis and Bayer V体育ios版. S. Hirota and Y. Kitagawa declare that they have no conflict of interest.

Ethical standards

All authors declare the trust and integrity of this review by their following the rules of good scientific practice, including the following: The manuscript has not been submitted to another journal simultaneously. The manuscript has not been published previously. A single study is not split into several parts to increase the quantity of submissions. No data have been fabricated or manipulated to support the conclusions. No data, text, or theories by others are presented as if they were those of the authors. Proper acknowledgments of other work have been given, quotation marks are used for verbatim copying of material, and permission has been secured for material that is copyrighted, if necessary. Consent to submit the article was received explicitly from all authors, as well as from the responsible authorities—tacitly or explicitly—at the institute/organization where the work was performed, before the work was submitted VSports最新版本. All authors contributed sufficiently to the scientific work and therefore share collective responsibility and accountability for the descriptions.

Figures

Fig. 1
Fig. 1
Pathological diagnosis of gastrointestinal stromal tumor (GIST) by immunohistochemistry and genotyping. The algorithm for the pathological diagnosis of GIST is shown. The number sign means solitary fibrous tumors should be ruled out. DOG1 discovered on GIST-1, HE hematoxylin–eosin staining
Fig. 2
Fig. 2
Diagnostic and therapeutic strategies for histologically undiagnosed gastric submucosal tumor (SMT) and histologically diagnosed gastric gastrointestinal stromal tumor (GIST). High-risk features include ulceration, irregular borders, internal heterogeneity, enlargement of regional lymph nodes, and an increase in size during follow-up. CT computed tomography, EUS endoscopic ultrasonography, EUS-FNA endoscopic-ultrasonography-guided fine-needle aspiration biopsy
Fig. 3
Fig. 3
Treatment algorithm for unresectable, metastatic, or recurrent gastrointestinal stromal tumor (GIST). Interventions include surgical resection, radiofrequency ablation, and transcatheter arterial embolization for patients with limited progression. Tyrosine kinase inhibitors (TKI) include imatinib, sunitinib, and regorafenib, BSC best supportive care, CR complete response, PD progressive disease, PR partial response, SD stable disease

References (VSports手机版)

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