Skip to main content
Erschienen in: Current Gastroenterology Reports 6/2011

01.12.2011 | Stomach and Duodenum (Joseph R. Pisegna, Section Editor)

Endoscopic Management of Gastrointestinal Stromal Tumors

verfasst von: Vinay Chandrasekhara, Gregory G. Ginsberg

Erschienen in: Current Gastroenterology Reports | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

Subepithelial lesions are increasingly being identified with improved endoscopic imaging technologies. Many of these lesions are now recognized as gastrointestinal stromal tumors (GISTs). Recent advances in immunohistochemistry have allowed for reliable differentiation of GISTs from other subepithelial tumors, thereby significantly improving our understanding of these lesions. The wealth of recent information and continual evolution in our understanding of GISTs has exposed some knowledge gaps pertaining to the optimal management of these lesions. In this article, we review the endoscopic management of GISTs as it relates to the identification, diagnosis and management of these lesions based on the best available literature and our own clinical experience to date.
Literatur
1.
Zurück zum Zitat Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.PubMedCrossRef Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.PubMedCrossRef
2.
Zurück zum Zitat Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.PubMedCrossRef Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83.PubMedCrossRef
3.
Zurück zum Zitat Heinrich MC, Corless CL, Duensing A, et al. PDGFRA activating mutations in gastrointestinal stromal tumors. Science. 2003;299:708–10.PubMedCrossRef Heinrich MC, Corless CL, Duensing A, et al. PDGFRA activating mutations in gastrointestinal stromal tumors. Science. 2003;299:708–10.PubMedCrossRef
4.
Zurück zum Zitat Lee CH, Liang CW, Espinosa I. The utility of discovered on gastrointestinal stromal tumor 1 (DOG1) antibody in surgical pathology-the GIST of it. Adv Anat Pathol. 2010;17:222–32.PubMedCrossRef Lee CH, Liang CW, Espinosa I. The utility of discovered on gastrointestinal stromal tumor 1 (DOG1) antibody in surgical pathology-the GIST of it. Adv Anat Pathol. 2010;17:222–32.PubMedCrossRef
5.
Zurück zum Zitat Novelli M, Rossi S, Rodriguez-Justo M, et al. DOG1 and CD117 are the antibodies of choice in the diagnosis of gastrointestinal stromal tumours. Histopathology. 2010;57:259–70.PubMedCrossRef Novelli M, Rossi S, Rodriguez-Justo M, et al. DOG1 and CD117 are the antibodies of choice in the diagnosis of gastrointestinal stromal tumours. Histopathology. 2010;57:259–70.PubMedCrossRef
6.
Zurück zum Zitat Ho MY, Blanke CD. Gastrointestinal stromal tumors: disease and treatment update. Gastroenterology. 2011;140:1372–6.PubMedCrossRef Ho MY, Blanke CD. Gastrointestinal stromal tumors: disease and treatment update. Gastroenterology. 2011;140:1372–6.PubMedCrossRef
7.
Zurück zum Zitat Nilsson B, Bumming P, Meis-Kindblom JM, et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era–a population-based study in western Sweden. Cancer. 2005;103:821–9.PubMedCrossRef Nilsson B, Bumming P, Meis-Kindblom JM, et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era–a population-based study in western Sweden. Cancer. 2005;103:821–9.PubMedCrossRef
8.
Zurück zum Zitat Tryggvason G, Gislason HG, Magnusson MK, et al. Gastrointestinal stromal tumors in Iceland, 1990–2003: the icelandic GIST study, a population-based incidence and pathologic risk stratification study. Int J Cancer. 2005;117:289–93.PubMedCrossRef Tryggvason G, Gislason HG, Magnusson MK, et al. Gastrointestinal stromal tumors in Iceland, 1990–2003: the icelandic GIST study, a population-based incidence and pathologic risk stratification study. Int J Cancer. 2005;117:289–93.PubMedCrossRef
9.
Zurück zum Zitat Tryggvason G, Kristmundsson T, Orvar K, et al. Clinical study on gastrointestinal stromal tumors (GIST) in Iceland, 1990–2003. Dig Dis Sci. 2007;52:2249–53.PubMedCrossRef Tryggvason G, Kristmundsson T, Orvar K, et al. Clinical study on gastrointestinal stromal tumors (GIST) in Iceland, 1990–2003. Dig Dis Sci. 2007;52:2249–53.PubMedCrossRef
10.
Zurück zum Zitat Agaimy A, Wunsch PH, Hofstaedter F, et al. Minute gastric sclerosing stromal tumors (GIST tumorlets) are common in adults and frequently show c-KIT mutations. Am J Surg Pathol. 2007;31:113–20.PubMedCrossRef Agaimy A, Wunsch PH, Hofstaedter F, et al. Minute gastric sclerosing stromal tumors (GIST tumorlets) are common in adults and frequently show c-KIT mutations. Am J Surg Pathol. 2007;31:113–20.PubMedCrossRef
11.
Zurück zum Zitat Chetty R. Small and microscopically detected gastrointestinal stromal tumours: an overview. Pathology. 2008;40:9–12.PubMedCrossRef Chetty R. Small and microscopically detected gastrointestinal stromal tumours: an overview. Pathology. 2008;40:9–12.PubMedCrossRef
12.
Zurück zum Zitat Hwang JH, Rulyak SD, Kimmey MB, et al. American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses. Gastroenterology. 2006;130:2217–28.PubMedCrossRef Hwang JH, Rulyak SD, Kimmey MB, et al. American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses. Gastroenterology. 2006;130:2217–28.PubMedCrossRef
13.
Zurück zum Zitat Hunt GC, Smith PP, Faigel DO. Yield of tissue sampling for submucosal lesions evaluated by EUS. Gastrointest Endosc. 2003;57:68–72.PubMedCrossRef Hunt GC, Smith PP, Faigel DO. Yield of tissue sampling for submucosal lesions evaluated by EUS. Gastrointest Endosc. 2003;57:68–72.PubMedCrossRef
14.
Zurück zum Zitat Cantor MJ, Davila RE, Faigel DO. Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection. Gastrointest Endosc. 2006;64:29–34.PubMedCrossRef Cantor MJ, Davila RE, Faigel DO. Yield of tissue sampling for subepithelial lesions evaluated by EUS: a comparison between forceps biopsies and endoscopic submucosal resection. Gastrointest Endosc. 2006;64:29–34.PubMedCrossRef
15.
Zurück zum Zitat Hwang JH, Saunders MD, Rulyak SJ, et al. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62:202–8.PubMedCrossRef Hwang JH, Saunders MD, Rulyak SJ, et al. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62:202–8.PubMedCrossRef
16.
Zurück zum Zitat Hunt GC, Rader AE, Faigel DO. A comparison of EUS features between CD-117 positive GI stromal tumors and CD-117 negative GI spindle cell tumors. Gastrointest Endosc. 2003;57:469–74.PubMedCrossRef Hunt GC, Rader AE, Faigel DO. A comparison of EUS features between CD-117 positive GI stromal tumors and CD-117 negative GI spindle cell tumors. Gastrointest Endosc. 2003;57:469–74.PubMedCrossRef
17.
Zurück zum Zitat Brand B, Oesterhelweg L, Binmoeller KF, et al. Impact of endoscopic ultrasound for evaluation of submucosal lesions in gastrointestinal tract. Dig Liver Dis. 2002;34:290–7.PubMedCrossRef Brand B, Oesterhelweg L, Binmoeller KF, et al. Impact of endoscopic ultrasound for evaluation of submucosal lesions in gastrointestinal tract. Dig Liver Dis. 2002;34:290–7.PubMedCrossRef
18.
Zurück zum Zitat Gress F, Schmitt C, Savides T, et al. Interobserver agreement for EUS in the evaluation and diagnosis of submucosal masses. Gastrointest Endosc. 2001;53:71–6.PubMedCrossRef Gress F, Schmitt C, Savides T, et al. Interobserver agreement for EUS in the evaluation and diagnosis of submucosal masses. Gastrointest Endosc. 2001;53:71–6.PubMedCrossRef
19.
Zurück zum Zitat Chak A, Canto MI, Rosch T, et al. Endosonographic differentiation of benign and malignant stromal cell tumors. Gastrointest Endosc. 1997;45:468–73.PubMedCrossRef Chak A, Canto MI, Rosch T, et al. Endosonographic differentiation of benign and malignant stromal cell tumors. Gastrointest Endosc. 1997;45:468–73.PubMedCrossRef
20.
Zurück zum Zitat Jeon SW, Park YD, Chung YJ, et al. Gastrointestinal stromal tumors of the stomach: endosonographic differentiation in relation to histological risk. J Gastroenterol Hepatol. 2007;22:2069–75.PubMedCrossRef Jeon SW, Park YD, Chung YJ, et al. Gastrointestinal stromal tumors of the stomach: endosonographic differentiation in relation to histological risk. J Gastroenterol Hepatol. 2007;22:2069–75.PubMedCrossRef
21.
Zurück zum Zitat Shah P, Gao F, Edmundowicz SA, et al. Predicting malignant potential of gastrointestinal stromal tumors using endoscopic ultrasound. Dig Dis Sci. 2009;54:1265–9.PubMedCrossRef Shah P, Gao F, Edmundowicz SA, et al. Predicting malignant potential of gastrointestinal stromal tumors using endoscopic ultrasound. Dig Dis Sci. 2009;54:1265–9.PubMedCrossRef
22.
Zurück zum Zitat Nickl N, Gress F, McClave S, et al. Hypoechoic intramural tumor study: final report [Abstract]. Gastrointest Endosc. 2002;55:AB98. Nickl N, Gress F, McClave S, et al. Hypoechoic intramural tumor study: final report [Abstract]. Gastrointest Endosc. 2002;55:AB98.
23.
Zurück zum Zitat Demetri GD, Benjamin RS, Blanke CD, et al. NCCN Task Force report: management of patients with gastrointestinal stromal tumor (GIST)–update of the NCCN clinical practice guidelines. J Natl Compr Canc Netw. 2007;5 Suppl 2:S1–S29.PubMed Demetri GD, Benjamin RS, Blanke CD, et al. NCCN Task Force report: management of patients with gastrointestinal stromal tumor (GIST)–update of the NCCN clinical practice guidelines. J Natl Compr Canc Netw. 2007;5 Suppl 2:S1–S29.PubMed
24.
Zurück zum Zitat Klapman JB, Logrono R, Dye CE, et al. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol. 2003;98:1289–94.PubMedCrossRef Klapman JB, Logrono R, Dye CE, et al. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol. 2003;98:1289–94.PubMedCrossRef
25.
Zurück zum Zitat Ando N, Goto H, Niwa Y, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc. 2002;55:37–43.PubMedCrossRef Ando N, Goto H, Niwa Y, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc. 2002;55:37–43.PubMedCrossRef
26.
Zurück zum Zitat Akahoshi K, Sumida Y, Matsui N, et al. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration. World J Gastroenterol. 2007;13:2077–82.PubMed Akahoshi K, Sumida Y, Matsui N, et al. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration. World J Gastroenterol. 2007;13:2077–82.PubMed
27.
Zurück zum Zitat Hoda KM, Rodriguez SA, Faigel DO. EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc. 2009;69:1218–23.PubMedCrossRef Hoda KM, Rodriguez SA, Faigel DO. EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc. 2009;69:1218–23.PubMedCrossRef
28.
Zurück zum Zitat • Sepe PS, Moparty B, Pitman MB, et al.: EUS-guided FNA for the diagnosis of GI stromal cell tumors: sensitivity and cytologic yield. Gastrointest Endosc 2009, 70:254–61. This study evaluated the diagnostic yield and sensitivity of EUS-FNA for patients with histologically confirmed c-kit-positive GISTs. Sensitivity of EUS-FNA for GISTs was 78.4%. • Sepe PS, Moparty B, Pitman MB, et al.: EUS-guided FNA for the diagnosis of GI stromal cell tumors: sensitivity and cytologic yield. Gastrointest Endosc 2009, 70:254–61. This study evaluated the diagnostic yield and sensitivity of EUS-FNA for patients with histologically confirmed c-kit-positive GISTs. Sensitivity of EUS-FNA for GISTs was 78.4%.
29.
Zurück zum Zitat Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010;71:913–9.PubMedCrossRef Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc. 2010;71:913–9.PubMedCrossRef
30.
Zurück zum Zitat Rodriguez SA, Faigel DO. Endoscopic diagnosis of gastrointestinal stromal cell tumors. Curr Opin Gastroenterol. 2007;23:539–43.PubMedCrossRef Rodriguez SA, Faigel DO. Endoscopic diagnosis of gastrointestinal stromal cell tumors. Curr Opin Gastroenterol. 2007;23:539–43.PubMedCrossRef
31.
Zurück zum Zitat Philipper M, Hollerbach S, Gabbert HE, et al. Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors. Endoscopy. 2010;42:300–5.PubMedCrossRef Philipper M, Hollerbach S, Gabbert HE, et al. Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors. Endoscopy. 2010;42:300–5.PubMedCrossRef
32.
Zurück zum Zitat Watson RR, Binmoeller KF, Hamerski CM, et al. Yield and performance characteristics of endoscopic ultrasound-guided fine needle aspiration for diagnosing upper GI tract stromal tumors. Dig Dis Sci. 2011;56:1757–62.PubMedCrossRef Watson RR, Binmoeller KF, Hamerski CM, et al. Yield and performance characteristics of endoscopic ultrasound-guided fine needle aspiration for diagnosing upper GI tract stromal tumors. Dig Dis Sci. 2011;56:1757–62.PubMedCrossRef
33.
Zurück zum Zitat • Ha CY, Shah R, Chen J, et al.: Diagnosis and management of GI stromal tumors by EUS-FNA: a survey of opinions and practices of endosonographers. Gastrointest Endosc 2009, 69:1039–44. This article demonstrates the substantial practice variations in diagnosing and management of GISTs and underscores the need for a standardized approach to these lesions. • Ha CY, Shah R, Chen J, et al.: Diagnosis and management of GI stromal tumors by EUS-FNA: a survey of opinions and practices of endosonographers. Gastrointest Endosc 2009, 69:1039–44. This article demonstrates the substantial practice variations in diagnosing and management of GISTs and underscores the need for a standardized approach to these lesions.
34.
Zurück zum Zitat Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Int J Surg Pathol. 2002;10:81–9.PubMedCrossRef Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Int J Surg Pathol. 2002;10:81–9.PubMedCrossRef
35.
Zurück zum Zitat • Fernandez-Esparrach G, Sendino O, Sole M, et al.: Endoscopic ultrasound-guided fine-needle aspiration and trucut biopsy in the diagnosis of gastric stromal tumors: a randomized crossover study. Endoscopy 2010, 42:292–9. This prospective randomized crossover study demonstrated that the diagnostic accuracy for gastric subepithelial tumors was not superior with EUS-trucut biopsy (55%) compared to EUS-FNA (52%). The main limitation of EUS-TCB was the high rate of technical failure; however, when an adequate sample was obtained with TCB, immunohistochemica phenotyping was almost always possible. • Fernandez-Esparrach G, Sendino O, Sole M, et al.: Endoscopic ultrasound-guided fine-needle aspiration and trucut biopsy in the diagnosis of gastric stromal tumors: a randomized crossover study. Endoscopy 2010, 42:292–9. This prospective randomized crossover study demonstrated that the diagnostic accuracy for gastric subepithelial tumors was not superior with EUS-trucut biopsy (55%) compared to EUS-FNA (52%). The main limitation of EUS-TCB was the high rate of technical failure; however, when an adequate sample was obtained with TCB, immunohistochemica phenotyping was almost always possible.
36.
Zurück zum Zitat Gines A, Wiersema MJ, Clain JE, et al. Prospective study of a Trucut needle for performing EUS-guided biopsy with EUS-guided FNA rescue. Gastrointest Endosc. 2005;62:597–601.PubMedCrossRef Gines A, Wiersema MJ, Clain JE, et al. Prospective study of a Trucut needle for performing EUS-guided biopsy with EUS-guided FNA rescue. Gastrointest Endosc. 2005;62:597–601.PubMedCrossRef
37.
Zurück zum Zitat Levy MJ, Jondal ML, Clain J, et al. Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA. Gastrointest Endosc. 2003;57:101–6.PubMedCrossRef Levy MJ, Jondal ML, Clain J, et al. Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA. Gastrointest Endosc. 2003;57:101–6.PubMedCrossRef
38.
Zurück zum Zitat Varadarajulu S, Fraig M, Schmulewitz N, et al. Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration. Endoscopy. 2004;36:397–401.PubMedCrossRef Varadarajulu S, Fraig M, Schmulewitz N, et al. Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration. Endoscopy. 2004;36:397–401.PubMedCrossRef
39.
Zurück zum Zitat Polkowski M, Gerke W, Jarosz D, et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy. 2009;41:329–34.PubMedCrossRef Polkowski M, Gerke W, Jarosz D, et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy. 2009;41:329–34.PubMedCrossRef
40.
41.
Zurück zum Zitat Demetri GD, von Mehren M, Blanke CD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347:472–80.PubMedCrossRef Demetri GD, von Mehren M, Blanke CD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347:472–80.PubMedCrossRef
42.
Zurück zum Zitat Buchdunger E, Cioffi CL, Law N, et al. Abl protein-tyrosine kinase inhibitor STI571 inhibits in vitro signal transduction mediated by c-kit and platelet-derived growth factor receptors. J Pharmacol Exp Ther. 2000;295:139–45.PubMed Buchdunger E, Cioffi CL, Law N, et al. Abl protein-tyrosine kinase inhibitor STI571 inhibits in vitro signal transduction mediated by c-kit and platelet-derived growth factor receptors. J Pharmacol Exp Ther. 2000;295:139–45.PubMed
43.
Zurück zum Zitat Casali PG, Jost L, Reichardt P, et al. Gastrointestinal stromal tumors: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19 Suppl 2:35–8. Casali PG, Jost L, Reichardt P, et al. Gastrointestinal stromal tumors: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19 Suppl 2:35–8.
44.
Zurück zum Zitat Demetri GD, van Oosterom AT, Garrett CR, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006;368:1329–38.PubMedCrossRef Demetri GD, van Oosterom AT, Garrett CR, et al. Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet. 2006;368:1329–38.PubMedCrossRef
45.
Zurück zum Zitat Melzer E, Fidder H. The natural course of upper gastrointestinal submucosal tumors: an endoscopic ultrasound survey. Isr Med Assoc J. 2000;2:430–2.PubMed Melzer E, Fidder H. The natural course of upper gastrointestinal submucosal tumors: an endoscopic ultrasound survey. Isr Med Assoc J. 2000;2:430–2.PubMed
46.
Zurück zum Zitat Lok KH, Lai L, Yiu HL, et al. Endosonographic surveillance of small gastrointestinal tumors originating from muscularis propria. J Gastrointestin Liver Dis. 2009;18:177–80.PubMed Lok KH, Lai L, Yiu HL, et al. Endosonographic surveillance of small gastrointestinal tumors originating from muscularis propria. J Gastrointestin Liver Dis. 2009;18:177–80.PubMed
47.
Zurück zum Zitat Huang WH, Feng CL, Lai HC, et al. Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors. Gastrointest Endosc. 2010;71:1076–81.PubMedCrossRef Huang WH, Feng CL, Lai HC, et al. Endoscopic ligation and resection for the treatment of small EUS-suspected gastric GI stromal tumors. Gastrointest Endosc. 2010;71:1076–81.PubMedCrossRef
48.
Zurück zum Zitat Lee IL, Lin PY, Tung SY, et al. Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy. 2006;38:1024–8.PubMedCrossRef Lee IL, Lin PY, Tung SY, et al. Endoscopic submucosal dissection for the treatment of intraluminal gastric subepithelial tumors originating from the muscularis propria layer. Endoscopy. 2006;38:1024–8.PubMedCrossRef
49.
Zurück zum Zitat Park YS, Park SW, Kim TI, et al. Endoscopic enucleation of upper-GI submucosal tumors by using an insulated-tip electrosurgical knife. Gastrointest Endosc. 2004;59:409–15.PubMedCrossRef Park YS, Park SW, Kim TI, et al. Endoscopic enucleation of upper-GI submucosal tumors by using an insulated-tip electrosurgical knife. Gastrointest Endosc. 2004;59:409–15.PubMedCrossRef
50.
Zurück zum Zitat Zhou PH, Yao LQ, Qin XY, et al.: Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc 2011 Mar 18. [Epub ahead of print]. Zhou PH, Yao LQ, Qin XY, et al.: Endoscopic full-thickness resection without laparoscopic assistance for gastric submucosal tumors originated from the muscularis propria. Surg Endosc 2011 Mar 18. [Epub ahead of print].
51.
Zurück zum Zitat Sun S, Ge N, Wang C, et al. Endoscopic band ligation of small gastric stromal tumors and follow-up by endoscopic ultrasonography. Surg Endosc. 2007;21:574–8.PubMedCrossRef Sun S, Ge N, Wang C, et al. Endoscopic band ligation of small gastric stromal tumors and follow-up by endoscopic ultrasonography. Surg Endosc. 2007;21:574–8.PubMedCrossRef
52.
Zurück zum Zitat Ledo-Rodriguez A, Ulla-Rocha JL, Baltar-Arias R, et al. Endoscopic resection of rectal gastrointestinal stromal tumor (GIST) using band ligation. Rev Esp Enferm Dig. 2009;101:870–1.PubMedCrossRef Ledo-Rodriguez A, Ulla-Rocha JL, Baltar-Arias R, et al. Endoscopic resection of rectal gastrointestinal stromal tumor (GIST) using band ligation. Rev Esp Enferm Dig. 2009;101:870–1.PubMedCrossRef
53.
Zurück zum Zitat Katoh T, Itoh Y, Mohri T, et al. Endoscopic enucleation of gastrointestinal stromal tumors of the stomach: report of five cases. World J Gastroenterol. 2008;14:2609–11.PubMedCrossRef Katoh T, Itoh Y, Mohri T, et al. Endoscopic enucleation of gastrointestinal stromal tumors of the stomach: report of five cases. World J Gastroenterol. 2008;14:2609–11.PubMedCrossRef
54.
Zurück zum Zitat Sasaki A, Koeda K, Obuchi T, et al. Tailored laparoscopic resection for suspected gastric gastrointestinal stromal tumors. Surgery. 2010;147:516–20.PubMedCrossRef Sasaki A, Koeda K, Obuchi T, et al. Tailored laparoscopic resection for suspected gastric gastrointestinal stromal tumors. Surgery. 2010;147:516–20.PubMedCrossRef
Metadaten
Titel
Endoscopic Management of Gastrointestinal Stromal Tumors
verfasst von
Vinay Chandrasekhara
Gregory G. Ginsberg
Publikationsdatum
01.12.2011
Verlag
Current Science Inc.
Erschienen in
Current Gastroenterology Reports / Ausgabe 6/2011
Print ISSN: 1522-8037
Elektronische ISSN: 1534-312X
DOI
https://doi.org/10.1007/s11894-011-0224-6

Weitere Artikel der Ausgabe 6/2011

Current Gastroenterology Reports 6/2011 Zur Ausgabe

Stomach and Duodenum (Joseph R. Pisegna, Section Editor)

Gastric Infection by Helicobacter pylori

Stomach and Duodenum (Joseph R. Pisegna, Section Editor)

Diagnosis and Management of Pernicious Anemia

Stomach and Duodenum (Joseph R. Pisegna, Section Editor)

Ménétrier’s Disease of the Stomach: A Clinical Challenge

Stomach and Duodenum (Joseph R. Pisegna, Section Editor)

Update on the Endoscopic Management of Peptic Ulcer Bleeding

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.