PATIENT MANAGEMENT TACTICS AT DIFFERENT STAGES OF GASTROINTESTINAL STROMAL TUMORS (GIST)

Abstract

Objective: The aim: To analyze the results of treatment even in limited groups of patients.

Patients and methods: Materials and methods: Clinical cases of GIST based on the materials of the surgical clinic of the Central Municipal Hospital in Uzhgorod (Transcarpathian region) were discussed. Clinical, ultrasound and CT monitoring was provided. CT dynamics were assessed according to RECIST 1.1.

Conclusion: Conclusions: Only surgery resection is enough in case of the "small" tumor originated from the stomach. Otherwise, in case of locally-widespread GIST it is expedient to refrain from radical surgical intervention. High-grade GIST was verified by the IHC examination with mutation of the KIT gene in exon 11. Imatinib mesylate 400 mg PO daily was prescribed. More than 1-year follow-up result: firstly more than 50% reduction of the tumor size with subsequent stabilization of the disease. Minimally invasive processes allow surgical interventions and do not require aggressive adjuvant therapy. The presence of a giant GIST is a serious diagnostic and treatment challenge. Only management of the patient by a multidisciplinary team allows to resolve diagnostic and treatment contradictions, to create the prospect of achieving complete or partial remission and long-term survival.

Keywords: Gastrointestinal stromal tumors (GIST); imatinib mesylate; immunohistochemical (IHC) study; surgical care; targeted therapy.