Management of Gastrointestinal Stromal Tumors
Gastrointestinal stromal tumors (GISTs) are nonepithelial tumors of the gastrointestinal (GI) tract that express genes for protein tyrosine kinase receptors, such as KIT and platelet-derived growth factor receptor alpha (PDGFRA). They are typically found in patients with early satiety, vague abdominal pain, gastrointestinal bleeding, or at times found incidentally in asymptomatic patients. GISTs are best studied with upper endoscopy and computed tomography (CT) to determine their resectability. Resectable tumors are best treated surgically, followed by adjuvant treatment with the tyrosine kinase inhibitor, imatinib, if there is a high risk for recurrence. Nonresectable tumors are best treated with imatinib first. All patients must undergo strict surveillance after treatment.