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Gastrointestinale Stromatumoren

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Chirurgische Onkologie

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Gastrointestinale Stromatumoren (GIST) sind erst 1998 als eine eigenständig definierte, von den interstitiellen Cajal’schen Zellen („Schrittmacher-Zellen des Gastrointestinaltraktes“) ausgehende Tumorentität identifiziert worden (Kindblom et al., 1998). Bis dahin wurden diese Tumoren meist Leiomyomen bzw. (Leiomyo-)Sarkomen zugeordnet. GIST weisen eine typische Aktivierung der kit-(CD 117)-bzw. seltener PDGFRA-Rezeptor-Tyrosinkinase (Heinrich et al., 2003; Hirota et al., 1998) auf (PDGFRA: platelet-derived growth factor receptor alpha). Diese Veränderungen werden durch genetische Mutationen bedingt. Die juxtamembrane Region des Rezeptors dürfte für die Kinaseinhibition verantwortlich sein, eine Mutation führt zum Verlust dieser Funktion und damit zu ungehemmter Aktivität der Tyrosinkinase (Corless et al., 2004) und konsekutiv zu Zellproliferation, Chemotaxis und Inhibition der Apoptose. Diese Erkenntnisse waren die Basis für eine rasche Evolution neuartiger therapeutischer Ansätze.

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Literatur

  • Benjamin RS, Rankin C, Fletcher C, Blanke C, Von Mehren M, Maki R, Bramwelll V, Baker L, Borden E, Demitri GD, for the Sarcoma Intergroup (2003) Phase III dose randomized study of imatinib mesylate (STI571) for GIST: Intergroup S0033 early results. Proc American Soc Clinic Oncol 22: 814

    Google Scholar 

  • Blanke CD, Joensuu H, Demetri GD, Heinrich MC, Eisenberg B, Fletcher J, Corless CL, Wehrle E, Sandau KB, von Mehren M (2006) Outcome of advanced gastrointestinal stromal tumor (GIST) patients treated with imatinib mesylate: four-year follow-up of a phase II randomized trial. ASCO. Abstract 7

    Google Scholar 

  • Blay JY, Bonvalot S, Casali P, Choi H, Debiec-Richter M, Dei Tos AP, Emile JF, Gronchi A, Hogendoorn PC, Joensuu H, Le Cesne A, McClure J, Maurel J, Nupponen N, Ray-Coquard I, Reichardt P, Sciot R, Stroobants S, van Glabbeke M, van Oosterom A, Demetri GD (2005) GIST consensus meeting panelists. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO. Ann Oncol 16(4): 566–578

    Article  PubMed  Google Scholar 

  • Brand B, Oesterhelweg L, Binmoeller KF, Sriram PV, Bohnhacker S, Seewald S, De Weerth A, Soehendra N (2002) Impact of endoscopic ultrasound for evaluation of submucosal lesions in gastrointestinal tract. Digestive and Liver Disease 34(4): 290–297

    Article  PubMed  CAS  Google Scholar 

  • Buchner-Steudel P, Fleig WE (2004) [Diagnosis and conservative treatment of gastrointestinal stromal tumors (GIST)]. Deutsche medizinische Wochenschrift (1946) 129(34–35): 1808–1810

    Google Scholar 

  • Bümming P, Andersson J, Meis-Kindblom JM, Klingenstierna H, Engström K, Stierner U, Wängberg B, Jansson S, Ahlman H, Kindblom LG, Nilsson B. (2003) Neoadjuvant, adjuvant and palliative treatment of gastrointestinal stromal tumours (GIST) with imatinib: a centre-based study of 17 patients. Br J Cancer 89(3): 460–464

    Article  PubMed  Google Scholar 

  • Clary BM, DeMatteo RP, Lewis JJ, Leung D, Brennan MF. (2001) Gastrointestinal stromal tumors and leiomyosarcoma of the abdomen and retroperitoneum: a clinical comparison. Ann Surg Oncol 2001(4): 290–299

    Article  Google Scholar 

  • Cobrin GM, Pittman RH, Lewis BS (2006) Increased diagnostic yield of small bowel tumors with capsule endoscopy. Cancer 107(1): 22–27

    Article  PubMed  Google Scholar 

  • Corless CL, Fletcher JA, Heinrich MC (2004) Biology of gastrointestinal stromal tumors. J Clin Oncol 22(18): 3813–3825

    Article  PubMed  CAS  Google Scholar 

  • DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF (2000) Two hundred gastrointestinal stromal tumors — Recurrence patterns and prognostic factors for survival. Annals of Surgery 231(1): 51–58

    Article  PubMed  CAS  Google Scholar 

  • DeMatteo RP, Antonescu CR, Chadaram V, You YN, McCall L, Maki R, Murgo A, Demetri G, Pisters P, Brennan MF (2005) Adjuvant imatinib mesylate in patients with primary high risk gastrointestinal stromal tumor (GIST) following complete resection: safety results from the US Intergroup phase II trial ACOSOG Z9000. ASCO. Abstract 9009

    Google Scholar 

  • Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, Heinrich MC, Tuveson DA, Singer S, Janicek M, Fletcher JA, Silverman SG, Silberman SL, Capdeville R, Kiese B, Peng B, Dimitrijevic S, Druker BJ, Corless C, Fletcher CD, Joensuu H. (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347(7): 472–480

    Article  PubMed  CAS  Google Scholar 

  • Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O’Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Human Pathol 33: 459–465

    Article  Google Scholar 

  • Gold JS, Dematteo RP (2006) Combined surgical and molecular therapy: the gastrointestinal stromal tumor model. Annals of surgery 244(2): 176–184

    Article  PubMed  Google Scholar 

  • Granger SR, Rollins MD, Mulvihill SJ, Glasgow RE (2006) Lessons learned from laparoscopic treatment of gastric and gastroesophageal junction stromal cell tumors. Surg Endosc 20(8): 1299–1304

    Article  PubMed  CAS  Google Scholar 

  • Heinrich MC, Corless CL, Demetri GD, Blanke CD, von Mehren M, Joensuu H, McGreevey LS, Chen CJ, Van den Abbeele AD, Druker BJ, Kiese B, Eisenberg B, Roberts PJ, Singer S, Fletcher CD, Silberman S, Dimitrijevic S, Fletcher JA (2003a) Kinase mutation and imatinib response in patients with metastatic gastrointestinal stromal tumors. J Clinic Oncol 21(23): 4342–4349

    Article  CAS  Google Scholar 

  • Heinrich MC, Corless CL, Duensing A, McGreevey L, Chen CJ, Joseph N, Singer S, Griffith DJ, Haley A, Town A, Demetri GD, Fletcher CD, Fletcher JA (2003b) PDGFRA activating mutations in gastrointestinal stromal tumors. Science 299(5607): 708–710

    Article  PubMed  CAS  Google Scholar 

  • Heinrich MC, Corless CL (2005) Gastric GI stromal tumors (GIST): the role of surgery in the era of targeted therapy. J Surgical Oncol 90: 195–207

    Article  Google Scholar 

  • Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y (1998) Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 279(5350): 577–580

    Article  PubMed  CAS  Google Scholar 

  • Hohenberger P, Reichardt P, Gebauer B, Wardelmann E (2004) [Gastrointestinal stromal tumors (GIST)-current concepts of surgical management]. Dtsch Med Wochenschr 129(34–35): 1817–1820

    Article  PubMed  CAS  Google Scholar 

  • Joensuu H, Fletcher C, Dimitrijevic S, Silberman S, Roberts P, Demetri G (2002) Management of malignant gastrointestinal stromal tumours. Lancet Oncol 3(11): 655–664

    Article  PubMed  CAS  Google Scholar 

  • Kindblom, LG, Remotti HE, Aldenborg F, Meis-Kindblom JM (1998) Gastrointestinal pacemaker cell tumor (GIPACT) — Gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. American J Pathology 152(5): 1259–1269

    CAS  Google Scholar 

  • Lau S, Tam KF, Kam CK, Lui CY, Siu CW, Lam HS, Mak KL (2004) Imaging of gastrointestinal stromal tumour (GIST). Clinical Radiol 59(6): 487–498

    Article  CAS  Google Scholar 

  • Lee JR, Joshi V, Griffin JW Jr, Lasota J, Miettinen M (2001) Gastrointestinal autonomic nerve tumor — Immunohistochemical and molecular identity with gastrointestinal stromal tumor. Am J Surgical Pathol 25(8): 979–987

    Article  CAS  Google Scholar 

  • Maki RG, Fletcher JA, Heinrich MC, Morgan JA, George S, Desai J, Scheu K, Fletcher CD, Baum C, Demetri GD (2005) Results from a continuation trial of SU11248 in patients (pts) with imatinib (IM)-resistant gasrointestinal stromal tumor (GIST). ASCO. Abstract 9011

    Google Scholar 

  • Matthews BD, Walsh RM, Kercher KW, Sing RF, Pratt BL, Answini GA, Heniford BT (2002) Laparoscopic vs open resection of gastric stromal tumors. Surgical Endoscopy and Other Interventional Techniques 16(5): 803–807

    PubMed  CAS  Google Scholar 

  • Miettinen M, Lasota J (2001) Gastrointestinal stromal tumors — definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Archiv 438(1): 1–12

    Article  PubMed  CAS  Google Scholar 

  • Miettinen M, El-Rifai W, El-Rifai H L, Sobin L, Lasota J (2002) Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: A review. Human Pathology 33(5): 478–483

    Article  PubMed  Google Scholar 

  • Mudan SS, Conlon KC, Woodruff JM, Lewis JJ, Brennan MF (2000) Salvage surgery for patients with recurrent gastrointestinal sarcoma: prognostic factors to guide patients selection. Cancer 88: 66–74

    Article  PubMed  CAS  Google Scholar 

  • Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG (2005) Gastrointestinal stromal tumors: The incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era — A population-based study in western Sweden. Cancer 103(4): 821–829

    Article  PubMed  Google Scholar 

  • Novitsky YW, Kercher KW, Sing RF, Heniford BT (2006) Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Annals of Surgery 243(6): 738–747

    Article  PubMed  Google Scholar 

  • Nowain A, Bhakta H, Pais S, Kanel G, Verma S (2005) Isolated hepatic metastasis from a gastrointestinal stromal tumor (GIST) 17 years after initial resection: need for long-term surveillance. J clinic gastroenterol 39(10): 925

    Article  Google Scholar 

  • Okai T, Minamoto T, Ohtsubo K, Minato H, Kurumaya H, Oda Y, Mai M, Sawabu N (2003) Endosonographic evaluation of c-kit-positive gastrointestinal stromal tumor. Abdominal Imaging 28(3): 301–307

    Article  PubMed  CAS  Google Scholar 

  • Raut CP, Posner M, Desai J, Morgan JA, George S, Zahrieh D, Fletcher CD, Demetri GD, Bertagnolli MM (2006) Surgical management of advanced gastrointestinal stromal tumors after treatment with targeted systemic therapy using kinase inhibitor. J Clinic Oncol 24: 2325–2331

    Article  CAS  Google Scholar 

  • Reichardt P, Pink D, Lindner T, Heinrich MC, Cohen PS, Wang Y, Yu R, Tsyrlova A, Dimitrijevic S, Blanke C (2005) A phase I/II trial of the oral PKC-inhibitor PKC412 (PKC) in combination with imatinib mesylate (IM) in patients (pts) with gastrointestinal stromal tumor (GIST)refractory to IM. ASCO. Abstract 3016

    Google Scholar 

  • Samiian L, Weaver M, Velanovich V (2004) Evaluation of gastrointestinal stromal tumors for recurrence rates and patterns of long-term follow-up. The American surgeon 70(3): 187–191

    PubMed  Google Scholar 

  • Sandrasegaran K, Rajesh A, Rushing DA, Rydberg J, Akisik FM, Henley JD (2005) Gastrointestinal stromal tumors: CT and MRI findings. Europ Radiol 15(7): 1407–1414

    Article  Google Scholar 

  • Singer S, Rubin BP, Lux ML, Chen CJ, Demetri GD, Fletcher CD, Fletcher JA (2002) Prognostic value of KIT mutation type, mitotic activity, and histologic subtype in gastrointestinal stromal tumors. J Clinical Oncol 20(18): 3898–3905

    Article  CAS  Google Scholar 

  • Taniguchi M, Nishida T, Hirota S, Isozaki K, Ito T, Nomura T, Matsuda H, Kitamura Y(1999) Effect of c-kit mutation on prognosis of gastrointestinal stromal tumors. Cancer Research 59(17): 4297–4300

    PubMed  CAS  Google Scholar 

  • Tran T, Davila JA, El-Serag HB (2005) The epidemiology of malignant gastrointestinal stromal tumors: An analysis of 1,458 cases from 1992 to 2000. American J Gastroenterol 100(1): 162–168

    Article  Google Scholar 

  • US National Institutes of Health Clinical Trials. 2006: www. clinicaltrials.gov/ct/show Van den Abbeele AD, Badawi RD (2002) Use of positron emission tomography in oncology and its potential role to assess response to imatinib mesylate therapy in gastrointestinal stromal tumors (GISTs). Europ J Cancer 38: S60–S65

    Google Scholar 

  • Van den Abbeele AD et al. (2002) Response to Imatinib mesylate (GleevecTM) therapy in patients with advanced gastrointestinal stromal tumors (GIST) is demonstrated by F-18-FDG-PET prior to anatomic imaging with CT. Radiol 225: 424

    Google Scholar 

  • Van den Abbeele AD, Badawi RD, Cliche JP, Janicek MJ, Tetrault R, Spangler T, Potter A, Merriam P, Silberman S, Dimitrijevic S, Demetri GD (2002) 18F-FDG-PET predicts response to imatinib mesylate (Glivec) in patients with advanced gastrointestinal stromal tumors (GIST). ASCO. Abstract 1610

    Google Scholar 

  • Von Mehren M, Blanke C, Joensuu H, Heinrich MC, Roberts P, Eisenberg B, Silberman S, Dimitrijevic S, Kiese B, Fletcher J, Fletcher C, Demetri GD (2002) High incidence of durable responses induced by imatinib mesylate (Glivec) in patients with unresectable and metastatic gastrointestinal stromal tumors (GIST). Proc American Soc Clinic Oncol 21: 403a

    Google Scholar 

  • Van Oosterom AT, Judson I, Verweij J, Stroobants S, Donato di Paola E, Dimitrijevic S, Martens M, Webb A, Sciot R, Van Glabbeke M, Silberman S, Nielsen OS; European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (2001) Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet 358(9291): 1421–1423

    Article  PubMed  Google Scholar 

  • Van Oosterom A, Dumez H, Desai J, Stroobants S, Van Den Abbeele AD, Clement P, Shand N, Kovarik J, Tsyrlova A, Demetri GD (2004) Combination signal transduction inhibition: a phase I/II trial of the oral mTOR-inhibitor everolimus (E, RAD001) and imatinib mesylate (IM) in patients (pts) with gastrointestinal stromal tumor (GIST) refractory to IM. Proc Clinical Oncol 22: 3002a

    Google Scholar 

  • Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, Pruim J, Price P (1999) Measurement of clinical and subclinical tumour response using [F-18]-fluorodeoxyglucose and positron emission tomography: Review and 1999 EORTC recommendations. Europ J Cancer 35(13): 1773–1782

    Article  CAS  Google Scholar 

  • Zalcberg JR, Verweij J, Casali PG, Le Cesne A, Reichardt P, Blay JY, Schlemmer M, Van Glabbeke M, Brown M, Judson IR; EORTC Soft Tissue and Bone Sarcoma Group, the Italian Sarcoma Group; Australasian Gastrointestinal Trials Group (2005) Outcome of patients with advanced gastro-intestinal stromal tumours crossing over to a daily imatinib dose of 800 mg after progression on 400 mg. Europ J Cancer 41(12): 1751–1757

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Abteilung für Allgemein- und Thoraxchirurgie, LKH Feldkirch, Universitäres Lehrspital, Carinagasse 47, 6800, Feldkirch, Österreich

    Prof. Dr. E. Wenzl

  2. Direktor des Charite Comprehensive Cancer Center, Campus Charité Mitte, Invalidenstraße 80, 10117, Berlin, Deutschland

    Prof. Dr. Dr. h.c. P. M. Schlag

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  1. Prof. Dr. E. Wenzl
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  1. stv. Vorstand der Universitätsklinik für Chirurgie Wien, Medizinische Universität Wien, Universitätsklinik für Chirurgie, Wien, Österreich

    Michael Gnant

  2. Direktor des Charité Comprehensive Cancer Center, Universitätsmedizin Berlin, Berlin, Deutschland

    Peter M. Schlag

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Wenzl, E., Schlag, P.M. (2008). Gastrointestinale Stromatumoren. In: Gnant, M., Schlag, P.M. (eds) Chirurgische Onkologie. Springer, Vienna. https://doi.org/10.1007/978-3-211-48613-9_25

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  • DOI: https://doi.org/10.1007/978-3-211-48613-9_25

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