Surgical Management of Germline Gastrointestinal Stromal Tumor.


Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 06 02 2023
accepted: 06 04 2023
medline: 7 7 2023
pubmed: 28 4 2023
entrez: 28 4 2023
Statut: ppublish

Résumé

Gastrointestinal stromal tumor (GIST) is the most common human sarcoma and usually results from a sporadic mutation in KIT or, less frequently, platelet-derived growth factor alpha (PDGFRA). Rarely, a germline mutation in the KIT, PDGFRA, succinate dehydrogenase (SDH), or neurofibromatosis 1 (NF1) gene is responsible for GIST. These tumors are found in the stomach (PDGFRA and SDH), small bowel (NF1), or a combination of both (KIT). There is a need to improve care for these patients regarding genetic testing, screening, and surveillance. Since most GISTs due to a germline mutation do not respond to tyrosine kinase inhibitors, the role of surgery is critical, especially when considering germline gastric GIST. However, in contrast to the established recommendation for prophylactic total gastrectomy in cadherin 1 (CDH1) mutation carriers once they reach adulthood, there are no formal guidelines as to the timing or extent of surgical resection for patients who are either carriers of a germline GIST mutation causing gastric GIST or have already developed gastric GIST(s). Surgeons must balance treating what is often multicentric, yet initially indolent disease with the chance of cure and the complications associated with total gastrectomy. Here, we consider the major issues in performing surgery in patients with germline GIST and illustrate the principles with a previously unreported patient harboring a germline KIT 579 deletion.

Identifiants

pubmed: 37115371
doi: 10.1245/s10434-023-13519-y
pii: 10.1245/s10434-023-13519-y
doi:

Substances chimiques

Proto-Oncogene Proteins c-kit EC 2.7.10.1
Receptor, Platelet-Derived Growth Factor alpha EC 2.7.10.1

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

4966-4974

Subventions

Organisme : NIH HHS
ID : R01 CA102613
Pays : United States
Organisme : NIH HHS
ID : T32 CA251063
Pays : United States
Organisme : NIH HHS
ID : R01 CA102613
Pays : United States
Organisme : NIH HHS
ID : T32 CA251063
Pays : United States

Informations de copyright

© 2023. Society of Surgical Oncology.

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Auteurs

Hyunjee V Kwak (HV)

Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Katherine J Tardy (KJ)

Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Andrew Allbee (A)

Department of Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Kristen Stashek (K)

Department of Pathology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Ronald P DeMatteo (RP)

Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. dematter@upenn.edu.

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