GASTRIC STROMAL TUMORS: A RETROSPECTIVE STUDY ABOUT 53 CASES

Aims Gastric stromal tumors are the most common malignant mesenchymal tumors of the stomach that develop at the expense of the muscularis of the gastric wall. The aim of our study is to focus on the diagnosis and therapeutic management of gastric stromal tumors and to show the benefit of long-term patient surveillance given the risk of recurrence.

Methods Retrospective study of a series of 53 cases of gastric stromal tumors diagnosed, treated and followed in the departments of Hepatology and Gastroenterology I and Visceral Surgery I of the Mohammed V Military Training Hospital of Rabat, in Morocco, on a period of 15 years, between April 2003 April 2018.

Results 53 patients including 39 men and 14 women with a mean age of 55 years. The circumstances of discovery were dominated by gastrointestinal bleeding noted in 52% cases and a palpable abdominal mass noted in 22%. The scanner has been the most used diagnostic tool in our series. The tumor sat preferentially in the lower third of the stomach with 39% of cases. The tumor size ranged from 0.5 to 34 cm with an average of 11 cm. 52% of cases had a high risk of malignancy. All patients were operated on. 51 patients (91%) underwent surgical resection for curative purposes. 2 patients could not be resected due to advanced locoregional invasion. 37 patients (60%) received adjuvant therapy with Imatinib. After an average follow-up of 35 months, one patient died as a result of the operation, 2 patients died from a cause other than TSG, 41 cases were in complete remission and 9 cases had locoregional recurrence.

Conclusions Complete surgical resection remains the treatment of choice for gastric stromal tumors for localized forms and Imatinib finds its place in metastatic forms. The monitoring of these tumors must be prolonged given the risk of recurrence.