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Overview
Gastrointestinal stromal tumors (GIST) are morphologically
spindle cell, epithelioid, or occasionally pleomorphic mesenchymal tumors of
the gastrointestinal tract as stated in the Introduction section.
GIST are the most common mesenchymal tumors originating from
the gastrointestinal tract. There is a high variation in the reported incidence
of GIST and details of these are in the Epidemiology
section.
GIST are associated with activation mutations in
the tyrosine kinase receptor KIT and/or the platelet-derived growth
factor receptor-α (PDGFRA). Mechanisms involved in this mutation and
development of GIST are in the Pathophysiology
section.
History and Physical Examination
The Clinical Presentation section enumerates the presenting symptoms of GIST. Among these symptoms include abdominal pain or discomfort, early satiety and gastrointestinal bleeding.
Diagnosis
Laboratory Tests and
Ancillaries and Imaging
studies to be considered in the work-up of patients suspected to have GIST are
discussed in these sections. It can be noted that biopsy is necessary to
confirm the diagnosis of GIST before the initiation of preoperative therapy.
Discussion of this procedure is in this section also.
GIST should be differentiated from other
gastrointestinal tract tumors and these other types of cancer are enumerated in
the Differential Diagnosis
section.
Management
Therapeutic options for preoperative or neoadjuvant therapy,
chemotherapy and systemic therapy for unresectable, progressive, or metastatic disease
are all discussed in the Pharmacological
Therapy section. Some of the
agents recommended include Imatinib, Pazopanib, Regorafenib, Entrectinib and
Larotrectinib.
Some patients may be considered for observation and recommendations
on this are enumerated in the Nonpharmacological
section.
Complete surgical excision is the standard treatment of
localized or potentially resectable GIST. Indications and surgical options are
discussed in detail in the Surgery section.
The Radiation Therapy
section discusses the different interventional radiology options for patients
with GIST.
The Monitoring
section features the parameters to consider in assessing patients being treated
for GIST and management of disease progression.
Gastrointestinal Stromal Tumor_Disease Summary
