Advanced Gastrointestinal Stromal Tumor (GIST)
Advanced Gastrointestinal Stromal Tumors (GIST)
Gastrointestinal stromal tumors (GISTs) are the most common type of mesenchymal tumor of the gastrointestinal (GI) tract and are estimated to account for 0.5-2% of all GI malignancies. GISTs primarily arise in the stomach or small intestine, but can occur in any portion of the GI tract including the duodenum, appendix, rectum, and colon. GISTs arise from the interstitial cells of Cajal located within the muscularis propria of the GI tract.
GISTs tend to be highly aggressive and difficult to treat. The most common treatment is surgical resection, accompanied by systemic therapies such as imatinib mesylate or other targeted therapies. Metastatic disease is much harder to control and usually involves multiple systemic therapies targeting specific mutations.
Signs and Symptoms
Patients with advanced GISTs may experience one or more of the following:
- Pain in the abdomen or back
- Nausea and vomiting
- Weight loss
- Anemia
- Fatigue
- Fever
Diagnosis
Advanced GISTs are difficult to diagnose and may require multiple tests and procedures to confirm. Common tests used in the diagnosis of advanced GIST include:
- Imaging tests, such as an X-ray, CT scan, MRI, or PET scan
- Endoscopy with biopsy
- Blood tests to check for the presence of certain tumor markers
Treatment
Treatment for advanced GIST will depend on the size and location of the tumor, the patient’s health, and the type of mutation present in the tumor. Common treatments for advanced GISTs include:
- Surgery – Surgical resection is the primary treatment for advanced GISTs and may involve partial or total removal of the tumor.
- Systemic therapies – Imatinib mesylate is the most commonly used systemic therapy for the treatment of advanced GISTs. Other targeted therapies may also be used.
- Radiation therapy and chemotherapy – In some cases, radiation therapy and chemotherapy may be used in combination with surgery and systemic therapies to treat advanced GISTs.
Prognosis
The prognosis for patients with advanced GIST is generally good, and most patients are able to successfully manage their condition with treatment. However, the prognosis can vary widely depending on the size and location of the tumor, the type of mutation present, and the patient’s response to therapy.