Clinical significance of surgery for gastric submucosal tumours with size enlargement during watchful waiting period

Yasuhiro Miyazaki, Kiyokazu Nakajima, Yukinori Kurokawa, Tsuyoshi Takahashi, Shuji Takiguchi, Hiroshi Miyata, Makoto Yamasaki, Seiichi Hirota, Toshirou Nishida, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background The true impact of surgery for small, asymptomatic and biopsy-negative gastric submucosal tumours (SMTs) with size enlargement during 'watchful waiting' period has not been fully understood. Methods From 2005 to 2012, 100 patients with gastric SMTs underwent surgery. Twenty-three of them with size enlargement during observation period were enrolled in the retrospective analysis. Data included clinicopathologic findings, genetic findings, operative outcomes and prognoses. Results All patients (13 males, 10 females), with median age of 54 (41-71), had their lesions detected by routine health check-up (n = 21) or incidentally (2). The tumours were 1.8 (0.5-4.0) cm in size at their initial detection, and enlarged up to 3.2 (2.0-7.0) cm at the operation during 63.0 (14.6-233.7) months. As surgical procedure, laparoscopic partial gastrectomy accounted for the majority (78.3%). Histologic examination revealed gastrointestinal stromal tumour (GIST) (21) and schwannoma (2). Although 16 out of 21 GISTs were categorised into 'Very low' (1), and 'Low' (13) risk according to Fletcher's classification, 'Intermediate' (5) and 'High' (2) risk were identified in the series. No recurrences/metastases were noted in 23.2 (0.9-87) months of postoperative follow-up. Conclusion Our study revealed the existence of high mitotic GISTs in asymptomatic, small gastric SMTs with size enlargement, and laparoscopic surgery was safely applied to majority of those cases. Prompt surgical intervention should therefore be considered for those lesions.

Original languageEnglish
Pages (from-to)2681-2688
Number of pages8
JournalEuropean Journal of Cancer
Volume49
Issue number12
DOIs
Publication statusPublished - Aug 1 2013
Externally publishedYes

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Watchful Waiting
Stomach
Laparoscopy
Neoplasms
Gastrointestinal Stromal Tumors
Neurilemmoma
Gastrectomy
Observation
Neoplasm Metastasis
Biopsy
Recurrence
Health

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Oncology

Cite this

Miyazaki, Y., Nakajima, K., Kurokawa, Y., Takahashi, T., Takiguchi, S., Miyata, H., ... Doki, Y. (2013). Clinical significance of surgery for gastric submucosal tumours with size enlargement during watchful waiting period. European Journal of Cancer, 49(12), 2681-2688. https://doi.org/10.1016/j.ejca.2013.04.006

Clinical significance of surgery for gastric submucosal tumours with size enlargement during watchful waiting period. / Miyazaki, Yasuhiro; Nakajima, Kiyokazu; Kurokawa, Yukinori; Takahashi, Tsuyoshi; Takiguchi, Shuji; Miyata, Hiroshi; Yamasaki, Makoto; Hirota, Seiichi; Nishida, Toshirou; Mori, Masaki; Doki, Yuichiro.

In: European Journal of Cancer, Vol. 49, No. 12, 01.08.2013, p. 2681-2688.

Research output: Contribution to journalArticle

Miyazaki, Y, Nakajima, K, Kurokawa, Y, Takahashi, T, Takiguchi, S, Miyata, H, Yamasaki, M, Hirota, S, Nishida, T, Mori, M & Doki, Y 2013, 'Clinical significance of surgery for gastric submucosal tumours with size enlargement during watchful waiting period', European Journal of Cancer, vol. 49, no. 12, pp. 2681-2688. https://doi.org/10.1016/j.ejca.2013.04.006
Miyazaki, Yasuhiro ; Nakajima, Kiyokazu ; Kurokawa, Yukinori ; Takahashi, Tsuyoshi ; Takiguchi, Shuji ; Miyata, Hiroshi ; Yamasaki, Makoto ; Hirota, Seiichi ; Nishida, Toshirou ; Mori, Masaki ; Doki, Yuichiro. / Clinical significance of surgery for gastric submucosal tumours with size enlargement during watchful waiting period. In: European Journal of Cancer. 2013 ; Vol. 49, No. 12. pp. 2681-2688.
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abstract = "Background The true impact of surgery for small, asymptomatic and biopsy-negative gastric submucosal tumours (SMTs) with size enlargement during 'watchful waiting' period has not been fully understood. Methods From 2005 to 2012, 100 patients with gastric SMTs underwent surgery. Twenty-three of them with size enlargement during observation period were enrolled in the retrospective analysis. Data included clinicopathologic findings, genetic findings, operative outcomes and prognoses. Results All patients (13 males, 10 females), with median age of 54 (41-71), had their lesions detected by routine health check-up (n = 21) or incidentally (2). The tumours were 1.8 (0.5-4.0) cm in size at their initial detection, and enlarged up to 3.2 (2.0-7.0) cm at the operation during 63.0 (14.6-233.7) months. As surgical procedure, laparoscopic partial gastrectomy accounted for the majority (78.3{\%}). Histologic examination revealed gastrointestinal stromal tumour (GIST) (21) and schwannoma (2). Although 16 out of 21 GISTs were categorised into 'Very low' (1), and 'Low' (13) risk according to Fletcher's classification, 'Intermediate' (5) and 'High' (2) risk were identified in the series. No recurrences/metastases were noted in 23.2 (0.9-87) months of postoperative follow-up. Conclusion Our study revealed the existence of high mitotic GISTs in asymptomatic, small gastric SMTs with size enlargement, and laparoscopic surgery was safely applied to majority of those cases. Prompt surgical intervention should therefore be considered for those lesions.",
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AU - Takiguchi, Shuji

AU - Miyata, Hiroshi

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N2 - Background The true impact of surgery for small, asymptomatic and biopsy-negative gastric submucosal tumours (SMTs) with size enlargement during 'watchful waiting' period has not been fully understood. Methods From 2005 to 2012, 100 patients with gastric SMTs underwent surgery. Twenty-three of them with size enlargement during observation period were enrolled in the retrospective analysis. Data included clinicopathologic findings, genetic findings, operative outcomes and prognoses. Results All patients (13 males, 10 females), with median age of 54 (41-71), had their lesions detected by routine health check-up (n = 21) or incidentally (2). The tumours were 1.8 (0.5-4.0) cm in size at their initial detection, and enlarged up to 3.2 (2.0-7.0) cm at the operation during 63.0 (14.6-233.7) months. As surgical procedure, laparoscopic partial gastrectomy accounted for the majority (78.3%). Histologic examination revealed gastrointestinal stromal tumour (GIST) (21) and schwannoma (2). Although 16 out of 21 GISTs were categorised into 'Very low' (1), and 'Low' (13) risk according to Fletcher's classification, 'Intermediate' (5) and 'High' (2) risk were identified in the series. No recurrences/metastases were noted in 23.2 (0.9-87) months of postoperative follow-up. Conclusion Our study revealed the existence of high mitotic GISTs in asymptomatic, small gastric SMTs with size enlargement, and laparoscopic surgery was safely applied to majority of those cases. Prompt surgical intervention should therefore be considered for those lesions.

AB - Background The true impact of surgery for small, asymptomatic and biopsy-negative gastric submucosal tumours (SMTs) with size enlargement during 'watchful waiting' period has not been fully understood. Methods From 2005 to 2012, 100 patients with gastric SMTs underwent surgery. Twenty-three of them with size enlargement during observation period were enrolled in the retrospective analysis. Data included clinicopathologic findings, genetic findings, operative outcomes and prognoses. Results All patients (13 males, 10 females), with median age of 54 (41-71), had their lesions detected by routine health check-up (n = 21) or incidentally (2). The tumours were 1.8 (0.5-4.0) cm in size at their initial detection, and enlarged up to 3.2 (2.0-7.0) cm at the operation during 63.0 (14.6-233.7) months. As surgical procedure, laparoscopic partial gastrectomy accounted for the majority (78.3%). Histologic examination revealed gastrointestinal stromal tumour (GIST) (21) and schwannoma (2). Although 16 out of 21 GISTs were categorised into 'Very low' (1), and 'Low' (13) risk according to Fletcher's classification, 'Intermediate' (5) and 'High' (2) risk were identified in the series. No recurrences/metastases were noted in 23.2 (0.9-87) months of postoperative follow-up. Conclusion Our study revealed the existence of high mitotic GISTs in asymptomatic, small gastric SMTs with size enlargement, and laparoscopic surgery was safely applied to majority of those cases. Prompt surgical intervention should therefore be considered for those lesions.

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