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雑誌文献

臨床外科67巻11号

2012年10月発行

文献概要

特集 外科医のための癌診療データ 臓器別最新データ 10.消化管間質腫瘍(GIST)

GISTの治療

著者: 石川卓1 神田達夫1 矢島和人1 小杉伸一1

所属機関: 1新潟大学大学院消化器・一般外科学分野

ページ範囲:P.274 - P.280

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覚えておきたいデータ

◆初発GISTの治療の原則は肉眼的完全切除である.高リスク群の完全切除後5年無再発生存率は40%前後である.

◆現在,腹腔鏡下手術の適応となるのは5.0cm以下の胃GISTである.5.1cm以上,胃原発以外のGISTではコンセンサスが得られていない.

◆SSGXVⅢ試験の結果から,高リスク群では少なくとも3年間の術後イマチニブ補助療法を行うことが望ましい.

◆術前イマチニブ補助療法の有効性,安全性についてはエビデンスがなく,臨床試験レベルの治療である.

参考文献

1)Fletcher CD, Berman JJ, Corless C, et al:Diagnosis of gastrointestinal stromal tumors:A consensus approach. Hum Pathol 33:459-465, 2002
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3)Joensuu H:Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol 39:1411-1419, 2008
4)Joensuu H, Vehtari A, Riihimäki J, et al:Risk of recurrence of gastrointestinal stromal tumour after surgery:an analysis of pooled population-based cohorts. Lancet Oncol 13:265-274, 2012
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7)日本癌治療学会,日本胃癌学会,GIST研究会(編):GIST診療ガイドライン.2010年11月改訂(第2版補訂版).金原出版,2010,pp1-138
8)Otani Y, Furukawa T, Yoshida M, et al:Operative indications for relatively small(2-5cm)gastrointestinal stromal tumor of the stomach based on analysis of 60 operated cases. Surgery 139:484-492, 2006
9)Nishimura J, Nakajima K, Omori T, et al:Surgical strategy for gastric gastrointestinal stromal tumors:laparoscopic vs. open resection. Surg Endosc 21:875-878, 2007
10)Catena F, Di Battista M, Fusaroli P, et al:Laparoscopic treatment of gastric GIST:report of 21 cases and literature's review. J Gastrointest Surg 12:561-568, 2008
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12)Goh BK, Chow PK, Chok AY, et al:Impact of the introduction of laparoscopic wedge resection as a surgical option for suspected small/medium-sized gastrointestinal stromal tumors of the stomach on perioperative and oncologic outcomes. World J Surg 34:1847-1852, 2010
13)Karakousis GC, Singer S, Zheng J, et al:Laparoscopic versus open gastric resections for primary gastrointestinal stromal tumors(GISTs):a size-matched comparison. Ann Surg Oncol 18:1599-1605, 2011
14)Davies AR, Ahmed W, Purkiss SF:Port site metastasis following diagnostic laparoscopy for a malignant Gastro-intestinal stromal tumour. World J Surg Oncol 6:55, 2008
15)Kim MD, Kang DH, Park JH, et al:Abdominal wound metastasis after laparoscopic surgery of gastrointestinal stromal tumor. Gut Liver 4:283-286, 2010
16)Dematteo RP, Ballman KV, Antonescu CR, et al:Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour:a randomised, double-blind, placebo-controlled trial. Lancet 373:1097-1104, 2008
17)Joensuu H, Eriksson M, Sundby Hall K, et al:One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor:a randomized trial. JAMA 307:1265-1272, 2012
18)Eisenberg BL, Harris J, Blanke CD, et al:Phase Ⅱ trial of neoadjuvant/adjuvant imatinib mesylate(IM)for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor(GIST):early results of RTOG 0132/ACRIN 6665. J Surg Oncol 99:42-47, 2009
19)Casali PG, Blay JY:Gastrointestinal stromal tumours:ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 21(Suppl 5):v98-v102, 2010

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1278

印刷版ISSN:0386-9857

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