**GIST**



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**Chapter 5**

**Provisional chapter**

**Gastric GIST**

**Gastric GIST**

Tamer Saafan

**Abstract**

**1. Introduction**

Tamer Saafan

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

DOI: 10.5772/intechopen.77297

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. The stomach is considered the most common site of GIST, and the most common histopathological type of GISTs is spindle cell. Mutational analysis may help in defining the management of GIST. Multiple stratification modules are available for the estimation of GISTs' prognosis. Surgery is considered the only curative option for GISTs. The discovery of KIT protein has allowed better identification of GISTs and has allowed creation of selective tyrosine kinase inhibitors which dramatically affected GIST management. Results of trials on neoadjuvant imatinib therapy are promising. Adjuvant imatinib therapy is recommended for 3 years and has proven to improve outcome in high-risk GISTs. New therapeutic agents are now available in case of imatinib resistance.

**Keywords:** GIST, gastric GIST, imatinib, tyrosine kinase inhibitors, primary GIST,

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract (GIT) [1, 2]. All GISTs are considered to have some degree of malignant potential [3]. The most common site of GISTs is the stomach (60%) [4]. Other common sites are jejunum and ileum (30%), duodenum (5%), rectum (2–3%), colon (1–2%), and esophagus (<1%) [4].

It has been estimated that GISTs comprise about 18% of all sarcomas and 80% of mesenchymal tumors found in the GIT [5]. GIST's true incidence has been underestimated as they were usually misdiagnosed as leiomyomas, leiomyosarcomas, and leiomyoblastomas [6]. A study which used the Surveillance, Epidemiology and End Results (SEER) data from the National Cancer Institute, reported that the incidence of GIST has increased from 0.028 cases

Follow-up of patients with GISTs depends on the type of GIST.

metastatic GIST, recurrent GIST, imatinib resistance, KIT, PDGFRA

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

http://dx.doi.org/10.5772/intechopen.77297

#### **Chapter 5 Provisional chapter**

#### **Gastric GIST Gastric GIST**

#### Tamer Saafan Tamer Saafan

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.77297

#### **Abstract**

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. The stomach is considered the most common site of GIST, and the most common histopathological type of GISTs is spindle cell. Mutational analysis may help in defining the management of GIST. Multiple stratification modules are available for the estimation of GISTs' prognosis. Surgery is considered the only curative option for GISTs. The discovery of KIT protein has allowed better identification of GISTs and has allowed creation of selective tyrosine kinase inhibitors which dramatically affected GIST management. Results of trials on neoadjuvant imatinib therapy are promising. Adjuvant imatinib therapy is recommended for 3 years and has proven to improve outcome in high-risk GISTs. New therapeutic agents are now available in case of imatinib resistance. Follow-up of patients with GISTs depends on the type of GIST.

DOI: 10.5772/intechopen.77297

**Keywords:** GIST, gastric GIST, imatinib, tyrosine kinase inhibitors, primary GIST, metastatic GIST, recurrent GIST, imatinib resistance, KIT, PDGFRA
