Journal de chirurgie

Bolnav cu Gist Gastric Gigant; Supraviețuire Nesperată Prezentare de Caz

Abstract

M Gheorghe1*, D Predescu1, N Copca2, Cristina Iosif3, F Băcanu4 and S Constantinoiu1

Background: Gastrointestinal Stromal Tumors (GIST) are rare neoplasms, with sever prognosis in advanced cases. Until the discovery of Tyrosin Kinase Inhibitors (TKI), the life expectancy was very poor for patient with metastatic tumors, postoperative relapses or unresectable disease. Introduction of TKI therapy provided an unexpected survival rate, controlling the disease with very good tolerance. Method: We present a case report representative for GIST pathology. It is the first case of our GIST series of patients, operated in General and Esophageal Surgery Clinic of “St. Mary” Hospital Bucharest. A multidisciplinary approach and a complex, multimodal, surgical and oncological treatment was applied, with good response confirmed by the long-term follow-up. A 79 years old patient was diagnosed in 2004 (at the age of 70 years) with giant gastric GIST. He underwent a total gastrectomy, splenectomy and left pancreatectomy; the resection was considered as R1 because the tumor capsule was not complete. The adjuvant treatment with TKI was started postoperatively for 2 years. The recurrence was noted one year after the adjuvant therapy stop. Then the TKI treatment was restarted with very good tolerance and control of disease at 9 years. Conclusion: The TKI therapy allows long-term control of the malignant GISTs in term of overall survival and quality of life, even when the surgical procedure is not optimal.