J Korean Med Sci.  2010 Nov;25(11):1543-1552. 10.3346/jkms.2010.25.11.1543.

Clinical Practice Guideline for Accurate Diagnosis and Effective Treatment of Gastrointestinal Stromal Tumor in Korea

• Kang YK
• Kim KM
• Sohn T
• Choi D
• Kang HJ
• Ryu MH
• Kim WH
• Yang HK

• KMID: 1779222
• DOI: http://doi.org/10.3346/jkms.2010.25.11.1543

Abstract

Despite the rarity in incidence and prevalence, gastrointestinal stromal tumor (GIST) has emerged as a distinct pathogenetic entity. And the clinical management of GIST has been evolving very rapidly due to the recent recognition of its oncogenic signal transduction pathway and the introduction of new molecular-targeted therapy. Successful management of GIST requires a multidisciplinary approach firmly based on accurate histopathologic diagnosis. However, there was no standardized guideline for the management of Korean GIST patients. In 2007, the Korean GIST study group (KGSG) published the first guideline for optimal diagnosis and treatment of GIST in Korea. As the second version of the guideline, we herein have updated recent clinical recommendations and reflected changes in diagnosis, surgical and medical treatments for more optimal clinical practice for GIST in Korea. We hope the guideline can be of help in enhancing the quality of diagnosis by members of the Korean associate of physicians involving in GIST patients's care and subsequently in achieving optimal efficacy of treatment.

Keyword

Guideline; Gastrointestinal Stromal Tumors; Diagnosis; Surgery; Treatment; Chemotherapy, Targeted; Imatinib; Sunitinib

MeSH Terms

Antineoplastic Agents/therapeutic use
Gastrointestinal Stromal Tumors/*pathology/surgery/*therapy
Humans
Neoadjuvant Therapy
Piperazines/therapeutic use
Proto-Oncogene Proteins c-kit/metabolism
Pyrimidines/therapeutic use
Recurrence
Republic of Korea
Tumor Markers, Biological/metabolism

Figure

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  Fig. 1 Typical photomicrograph of spindle cell gastrointestinal stromal tumor (A: H&E, ×400) and c-kit stained in the cytoplasm and cytoplasmic membranes (B: Immunohistochemical stain, ×400). Blood vessels within the tumor are negative for c-kit (B).

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  Fig. 2 Typical photomicrograph of epithelioid gastrointestinal stromal tumor (A: H&E, ×400) and c-kit stained in the cytoplasm and cytoplasmic membranes (B: Immunohistochemical stain, ×400).

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  Fig. 3 Algorithm to diagnose gastrointestinal stromal tumor based on immunohistochemistry.

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