Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2021; 13(8): 959-969
Published online Aug 15, 2021. doi: 10.4251/wjgo.v13.i8.959
Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors
Yun-Zi Wu, Yang Li, Ming Wu, Xiao-Hao Zheng, Yan-Tao Tian, Yi-Bin Xie
Yun-Zi Wu, Yang Li, Xiao-Hao Zheng, Yan-Tao Tian, Yi-Bin Xie, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Ming Wu, Department of Gastric Surgery, Yun Cheng Center Hospital, Yucheng 043300, Shanxi Province, China
Author contributions: Wu YZ, Xie YB and Li Yang designed the study; Wu YZ and Wu Ming performed the research; Wu YZ and Zheng YH analyzed the data; Wu YZ and Li Yang wrote the paper; Xie YB and Tian YT revised the manuscript for final submission.
Supported by CAMS Initiative for Innovative Medicine, No. 2016-I2M-1-007.
Institutional review board statement: The study was reviewed and approved by the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
Informed consent statement: All study participants or their legal guardian provided written informed consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other individuals or organizations that inappropriately influenced our work and that there is no professional or other personal interest of any nature in any product, service and/or company that could be construed as influencing the position presented in or the review of the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Bin Xie, MD, Chief Doctor, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuan South Lane, Chaoyang District, Beijing 100021, China. yibinxie_2003@163.com
Received: June 9, 2021
Peer-review started: June 9, 2021
First decision: June 15, 2021
Revised: June 18, 2021
Accepted: July 5, 2021
Article in press: July 5, 2021
Published online: August 15, 2021
ARTICLE HIGHLIGHTS
Research background

Duodenal gastrointestinal stromal tumors (DGISTs) rarely break the tumor capsule and lymph node metastases seldom occur. However, the duodenum is located near the pancreas and biliary tract. Traditional Whipple surgery results in severe injury; thus, it is necessary to preserve as much normal tissue as possible.

Research motivation

The present study attempted to identify the factors influencing the surgical treatment of DGISTs and to determine the best surgical procedure.

Research objectives

This study aimed to investigate the factors influencing DGIST surgery and provide advice regarding the best surgical technique.

Research methods

The clinicopathological data of patients with DGISTs who underwent surgery from January 1999 to January 2021 were analyzed. The Student t test or Mann-Whitney U-test and χ2 test or Fisher’s exact test were used to identify differences between the two groups of patients treated with different surgical techniques. Logistic regression analysis was carried out to assess the relevant factors influencing the choice of surgical procedure.

Research results

There were no differences in age, mitotic figures and complications between these two groups, while the tumor size, tumor location, risk grade, postoperative hospital time, and abdominal drainage time showed statistically significant differences. Using univariate logistic analysis, if the tumor was ≥ 5.0 cm in size, located in the descending part of the duodenum or the risk grade was medium or high, Whipple surgery was performed.

Research conclusions

If the primary tumor was in the descending part of the duodenum, was ≥ 5.0 cm in size and the risk grade was medium or high, Whipple surgery was performed.

Research perspectives

Although we investigated the factors influencing the surgical treatment of duodenal gastrointestinal stromal tumors and assessed the best surgical procedure for these patients, a prospective study should be performed to confirm these findings.