J Korean Med Assoc.  2007 Sep;50(9):830-841. 10.5124/jkma.2007.50.9.830.

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

• Korean Gastrointestinal Stromal Tumor Study Group
• Kang YK

• KMID: 2184924
• DOI: http://doi.org/10.5124/jkma.2007.50.9.830

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 in localized and advanced stages requires a multidisciplinary approach firmly based on accurate histopathologic diagnosis. However, standardized guidelines for the management of Korean GIST patients do not exist. This study was performed to provide a guideline for standardized diagnosis and treatment for GIST in Korea. Expert panel members of the Korean GIST Study Group (KGSG) thoroughly reviewed the relevant literature including European Society of Medical Oncology and National Comprehensive Cancer Network guidelines and shared their experience and opinions to make a consensus on twenty-five topics related with pathologic diagnosis, surgical management, and medical treatment of GIST. The consensus described in this article was presented as the basis for a guideline of diagnosis and treatment for patients with GIST that would be used to facilitate the optimal clinical practice in Korea.

Keyword

Guideline; GIST; Diagnosis; Surgery; Imatinib; Sunitinib

MeSH Terms

Consensus
Diagnosis*
Gastrointestinal Stromal Tumors*
Humans
Imatinib Mesylate
Incidence
Korea*
Medical Oncology
Prevalence
Signal Transduction

Figure

• 

  Figure 1. Photograph of the representative findings of gastrointestinal stromal tumors (GISTs). A) Epithelioid type GIST. B) Spindle cell type GIST. C) Mixed epithelioid and spindle cell type GIST. D) Hyaline changes observed in GIST. E) Myxoid changes observed in GIST. F) Ischemic tumor necrosis observed in GIST.

• 

  Figure 2. Immunohistochemical staining of c?kit in gastrointestinal stromal tumor. c?kit is diffusely positive in the cytoplasm and membranes (A&B). In this picture, internal negative control is vascular endothelial cells. Sometimes, c?kit is more intensely stained along the membrane (C). Less frequently, perinuclear golgi?like staining can be observed (D).

• 

  Figure 3. Algorithm to diagnose gastrointestinal stromal tumors based on immunohistochemistry.

Reference

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