Evolving patterns of gastrointestinal stromal tumor presentation, management, and outcome over three decades: A Middle Eastern retrospective study

Table 8 Summary of recent studies on the treatment options for gastrointestinal stromal tumor

Ref.	Patients/duration/intervention	Results	Comment
Wang et al[41]	1015 GIST cases between 2010-2019 received radical surgery	In intermediate-risk patients, the Ki-67 index and postoperative TKI treatment are closely related to prognosis however, if their primary tumor is the stomach, the value of TKI-targeted therapy after surgery seems not necessary	In some high-risk patients, the prognosis can be improved by prolonging the treatment time of TKI
Wu et al[42]	105 GIST cases between 2019-2021 (LAP vs endoscopic)	LAP and endoscopic resection, have good curative result, safety, and prognosis in the treatment of GIST. Endoscopic resections have less trauma, faster recovery, shorter hospitalization time, and lower cost compared with LAP
Lei et al[43]	177 cases with 2-5 cm gastric GISTs between 2007-2019 (endoscopic vs surgery)	The endoscopic group had shorter anal exhaust time and less hospital cost. The rate of complications and reoperation in the endoscopic group was relatively higher than the surgical group. No significant difference observed in recurrence-free survival or overall survival between two groups	LAP is usually recommended for GISTs of ≤ 5 cm diameter, and for the greater curvature of the stomach and the front wall of the fundus
Yang et al[44]	Meta-analysis included 485 cases before April 2017 (open and LAP wedge resection)	The operation time was similar between the 2 groups LAP showed less blood loss earlier time to flatus, shorter hospital stays, and a decreased overall complication rate compared with open surgery	Long-term follow-up showed no obvious difference between the two groups
Yin et al[45]	91 patients (LAP, laparoscopic and endoscopic cooperative surgery, or endoscopic submucosal dissection surgeries for gastric GISTs ≤ 5 cm)	The operative time and intraoperative blood loss in endoscopic submucosal dissection were significantly less than that in endoscopic cooperative surgery and LAP groups. No statistical difference was found in the postoperative recovery and complications among the three groups	The decision for a minimally invasive intervention should be according to the tumor size & location, pattern of tumor growth, and experience of surgeons
Zhang et al[46]	275 gastric submucosal tumors < 5 cm, 2013 to January 2017 (endoscopic vs LAP)	The endoscopic resection patients had shorter hospitalization time, postoperative hospital stay and diet recovery time. The LAP had shorter operation time, less cost and less blood loss	It is difficult to locate via LAP in some small endogenous GIST. LAP is inconvenient and difficult to expose lesions of the cardia or upper part of the stomach close to the fundus

GIST: Gastrointestinal stromal tumor; LAP: Laparoscopic resection; TKI: Tyrosine kinase inhibitors.