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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(01): 068-076
DOI: 10.1055/s-0041-1740297
Review Article

Prognostic Factors and Management of Colorectal Gastrointestinal Stromal Tumors

Nuno Rafael Pereira Reis 
1   Department of Surgery and Physiology, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
,
Laura Elisabete Ribeiro Barbosa 
1   Department of Surgery and Physiology, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
2   Department of General Surgery, Centro Hospitalar Universitário São João, Serviço de Cirurgia Geral, Porto, Portugal.
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Abstract

Introduction The gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. Even though it can be found in any location of the digestive tract, the colorectal GIST is rare. With this study, we aim to review the current knowledge regarding the prognosis and management of colorectal GIST.

Methods A literature search was conducted in PubMed, and 717 articles were collected. After analyzing these studies, 60 articles were selected to use in this review.

Results The mitotic index, as well as tumor size and location were identified as good discriminators of prognosis in various studies. Surgery remains the only curative therapy for potentially resectable tumors. However, even after surgical resection, some patients develop disease recurrence and metastasis, especially those with high-risk tumors. Therefore, surgical resection alone might be inadequate for the management of all colorectal GISTs. The discovery of GIST's molecular pathway led to a shift in its therapy, insofar as tyrosine kinase inhibitors became part of the treatment schemes for this tumor, revolutionizing the treatment's outcome and prognosis.

Discussion/Conclusion The controversy concerning colorectal GIST prognosis and treatment can be, in part, attributed to the limited number of studies in the literature. In this review, we gathered the most recent knowledge about the prognosis and management of GIST in this rare location and propose two algorithms for its approach. Lastly, we highlight the importance of an individualized approach in the setting of a multidisciplinary team.

Keywords

gastrointestinal stromal tumors - colorectal neoplasms - therapeutics - prognosis

Sources of Support of Study Development

None




Publication History

Received: 25 March 2021

Accepted: 06 August 2021

Article published online:
31 January 2022

© 2022. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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