Beschreibung:
<jats:p> 222 </jats:p><jats:p> Background: Gastrointestinal stromal tumour (GIST) is the most common mesenchymal tumour of digestive tract, presesting less than 1% of all digestive tumours. This study is analyse a group of patients treated surgically due to GIST. Methods: The group of 71 patients consisted of 34 males and 37 females between the age of 32 and 89 (M 44-83, average 64.6; F 43-89, average 66.5) treated surgically due to GIST. Analysis included clinical symptoms, diagnosis, surgical treatment, location of tumour, outcome of histopathological and immunohistochemical examinations, recurrence of disease, metastases and mortality rate. Results: Among 71 GIST patients 35 were with low aggressivity level, 14 with average and 22 with high. Most of patients were subjected to surgical treatment (laparoscopic or open) on a planned basis and in 3 cases on an emergency basis due to the intensified symptoms of intestinal occlusion, 50 patients were found to have gastric tumours, 3 duodenal tumours, 13 small intestine tumours, 3 colonic tumours, 2 rectal tumours. Histopathological examination outcome showed radical tumour resection in all cases Tumours of size exceeding 5 cm in diameter were found in 30 cases. Most patients had definited type of mutation. Predominated mutations localized in exon 11. There was no perioperative mortality rate. During follow up (from 1 month to 130 months), 16 patients died, including 4 due to GIST dissemination, 4 were diagnosed with recurrence of GIST and two of them were qualified for imatinib treatment others died of cardio-vasculary diseases. Most of patient underwent resection of tumor with safety margin of gastric wall (21), 5 patients were treated by laparoscopic surgery. All patients, who subsequently had postoperative recurrence or died due to GIST metastases, were diagnosed with highly aggressive tumor. Conclusions: GIST - still unknown treatment possibilities [surgery, imatinib, other specific tyrosine kinase inhibitors, what next?]. Analysis of cases from our study confirms that large size of tumor (diameter > 5cm) and high mitotic index (MI >5/50 HPF) are factors associated with bad prognosis (metastases, recurrence). </jats:p>