Review article: the biology, diagnosis and management of gastrointestinal stromal tumours

Aliment Pharmacol Ther. 2014 Jun;39(12):1376-86. doi: 10.1111/apt.12761. Epub 2014 Apr 20.

Abstract

Background: Gastrointestinal stromal tumours (GIST) are the most common mesenchymal tumours of the gastrointestinal tract with an increasing incidence.

Aims: To review the biology, diagnosis and treatment of gastrointestinal stromal tumours.

Methods: A PubMed search using the phrases 'Gastrointestinal stromal tumor', 'imatinib', 'c-kit'.

Results: The diagnosis of GIST is established by histology supplemented by the immunohistochemical marker CD117, which is positive in 95% of cases. The most common site of the tumour is the stomach. Most GIST are benign with 20-30% malignant. Five-year survival for malignant GIST ranges between 35% and 65% and depends primarily on tumour size, mitotic index and location. The malignant behaviour of GIST is best assessed by invasion of adjacent structures and distant metastases. The gold standard for treatment is surgical resection. Imatinib, a tyrosine kinase inhibitor, is the primary therapy for unresectable, recurrent or metastatic disease.

Conclusions: Gastrointestinal stromal tumours are rare tumours of the gastrointestinal tract and they vary in presentation. When surgical resection is not achievable, imatinib is the treatment of choice.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Benzamides / therapeutic use
  • Gastrointestinal Neoplasms* / diagnosis
  • Gastrointestinal Neoplasms* / epidemiology
  • Gastrointestinal Neoplasms* / genetics
  • Gastrointestinal Neoplasms* / therapy
  • Gastrointestinal Stromal Tumors* / diagnosis
  • Gastrointestinal Stromal Tumors* / epidemiology
  • Gastrointestinal Stromal Tumors* / genetics
  • Gastrointestinal Stromal Tumors* / therapy
  • Humans
  • Imatinib Mesylate
  • Piperazines / therapeutic use
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines / therapeutic use

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Imatinib Mesylate