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Laparoscopic Surgery Demonstrates Feasibility, Safety for Gastrointestinal Stromal Tumors
Study findings reveal laparoscopic surgery is safe and feasible for large gastric gastrointestinal stromal tumors (GISTs) sized between 5 and 8 cm. Study authors wrote, “resection of large GISTs by laparoscopic has been controversial.” The current results are an extension of a previous study and report on long-term oncological outcomes.
Between 2002 and 2018, the study enrolled 66 consecutive patients with GISTs sized 5 to 8 cm at the National Taiwan University Hospital. Of all the patients, 30 underwent open surgery, and 36 underwent laparoscopic surgery. In the open surgery group, the mean tumor size was 6 cm (± 0.83 cm), compared with 6.3 cm (±1.07 cm) in the laparoscopic group (P = .3). Clinicopathological data, perioperative and oncological outcomes were assessed.
The median follow-up time for all patients was 108 months (97 in the laparoscopic group vs 122 in the open surgery group). The 5-year recurrence-free survival was 100% in the open group, vs 94.2% in the laparoscopic group (P = .2). All but 3 patients (1 in the open surgery group vs 2 in the laparoscopic group) remained disease-free at the time of data cutoff. Those 3 patients who experienced recurrences went on to achieve stable disease while on treatment with imatinib.
Between the 2 groups, operation time, blood loss, and post-operative complications were similar. The mean hospital stay was shorter for those patients in the laparoscopic group (8.8 days vs 12 days in the open surgery group), but there was not a statistically significant difference. There were 8 deaths total during the follow-up period with none attributed to GIST-related causes.
“Our data showed that laparoscopic surgery for gastric GIST between 5 and 8 cm was safe and oncologically feasible,” the study authors concluded.
Source:
Lin SC, Yen HH, Lee PC, and Lai IR. Oncological outcomes of large gastrointestinal stromal tumors treated by laparoscopic resection. Surg Endosc. Published October 25, 2022. doi:10.1007/s00464-022-09693-x
