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1
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Annicchiarico A, Montali F, Baldinu M, Casali L, Virgilio E, Costi R. Leiomyosarcoma of the rectum: A systematic review of recent literature. J Surg Oncol 2024; 129:365-380. [PMID: 37814590 DOI: 10.1002/jso.27481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
Leiomyosarcomas (LMSs) are rare tumors originating from the muscular layer. We performed a literature review of cases of confirmed rectal leiomyosarcomas (rLMSs) to clarify the history of such an infrequent tumor arising at such an uncommon location. In this research local recurrence was related to poorly differentiated rLMS and no other association between recurrence and any criteria was found. Concerning overall survival (OS), rLMS patients developing recurrence presented shorter longevity compared with the group without.
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Affiliation(s)
- Alfredo Annicchiarico
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Filippo Montali
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Manuel Baldinu
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Lorenzo Casali
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Edoardo Virgilio
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Renato Costi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
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2
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Qu H, Xu Z, Ren Y, Gong Z, Ju RH, Zhang F, Kang H, Xu Y, Chen X. Recent Advancements in the Treatment of Rectal Gastrointestinal Stromal Tumor: In Era of Imatinib. Cancer Manag Res 2022; 14:1141-1152. [PMID: 35321404 PMCID: PMC8934706 DOI: 10.2147/cmar.s352860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/18/2022] [Indexed: 12/30/2022] Open
Abstract
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor of the gastrointestinal tract, with an annual incidence of 10–15 cases per million. However, rectal GIST has a low incidence, accounting for approximately 0.1% of all rectal tumors. The treatment of rectal GISTs is still controversial and the relative unified guidelines and consensus opinions are inadequate. Treatment is based primarily on the clinical experience of the physician. The widespread application of neoadjuvant imatinib therapy allows diversification of treatment, especially in the choice of surgical methods. Herein, we reviewed the most recent literature and summarized the new progress in rectal tumor treatment, with the aim of providing patients with more systematic and individualized therapeutic strategies.
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Affiliation(s)
- Hui Qu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - ZhaoHui Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - YanYing Ren
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
| | - ZeZhong Gong
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Ri Hyok Ju
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Fan Zhang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
| | - HaoNan Kang
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Yang Xu
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Dalian Medical University, Dalian, People’s Republic of China
| | - Xin Chen
- Department of Hernia and Colorectal Surgery, The Second Hospital of Dalian Medical University, Dalian, 116023, People’s Republic of China
- Correspondence: Xin Chen, Tel +86 17709872266, Email
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3
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Guevara-Martínez J, Toribio-Vázquez C, Noire FPL, Cantero R. Transanal Minimally Invasive Surgery for Local Excision of a Rectal Schwannoma. Dis Colon Rectum 2022; 65:e1-e3. [PMID: 34882634 DOI: 10.1097/dcr.0000000000002041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Takahashi H, Takemasa I, Doki Y, Eguchi H. ASO Author Reflections: Opening up the Future with Transanal Minimally Invasive Surgery of Fine Techniques. Ann Surg Oncol 2021; 28:3777-3778. [PMID: 33646428 DOI: 10.1245/s10434-021-09613-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Hidekazu Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, 565-0871, Osaka, Japan.
| | - Ichiro Takemasa
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Chuo-ku, Sapporo, S1 W16, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, 565-0871, Osaka, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita, 565-0871, Osaka, Japan
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5
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Takahashi H, Takemasa I, Miyoshi N, Uemura M, Yamamoto H, Mizushima T, Doki Y, Eguchi H. Application of Local Hyaluronic Acid Injection in Transanal Minimally Invasive Surgery for Anterior Rectal GIST. Ann Surg Oncol 2021; 28:3774. [PMID: 33454880 DOI: 10.1245/s10434-020-09569-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/26/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Hidekazu Takahashi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
| | - Ichiro Takemasa
- Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan
| | - Norikatsu Miyoshi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Mamoru Uemura
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Hirofumi Yamamoto
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Tsunekazu Mizushima
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Hidetoshi Eguchi
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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6
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Yang Z, Guo W, Huang R, Hu M, Wang H, Wang H. Transanal versus nontransanal surgery for the treatment of primary rectal gastrointestinal stromal tumors: a 10-year experience in a high-volume center. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:201. [PMID: 32309348 PMCID: PMC7154442 DOI: 10.21037/atm.2020.01.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Rectal gastrointestinal stromal tumor (GIST) is a rare digestive disease that has a distinct malignant tendency compared to that of gastric-derived GIST. At present, there is still no standard, and the surgical approach to rectal GIST is controversial. Methods The clinicopathological data and prognosis of rectal GIST patients admitted to the Sixth Affiliated Hospital of Sun Yat-sen University from 1998.01.01 to 2018.12.31 were collected retrospectively. All cases were divided into either the transanal (TA) group or the nontransanal (NTA) group. Results A total of 537 GIST cases were treated in 10 years, including 82 rectal GIST cases (64 cases underwent surgical resection, including 29 cases in the TA group and 35 cases in the NTA group). Preoperative neoadjuvant therapy (P=0.003), postoperative adjuvant therapy (P=0.017), operative time (P=0.013), blood loss (P=0.038), anus-preserver (P=0.048), 30-day complication rate (P=0.000), time to flatus (P=0.036), hospital stays (P=0.011), distance from the anus (P=0.047), tumor size (P=0.002), mitotic count (P=0.035) and National Institutes of Health (NIH) criteria (P=0.000) were significantly different between these two groups (all P<0.05). The median follow-up time was 41 (range, 1–122) months. Twelve patients had recurrence and metastasis, and 4 patients died. The 5-year disease-free survival (DFS) and overall survival (OS) were 74.4% and 91.2%, respectively, in the whole group. There were no statistically significant differences between the TA group and the NTA group at 5-year DFS (81.3% vs. 79.0%, P=0.243) and OS (88.7% vs. 93.3%, P=0.308). Conclusions In the treatment of rectal GIST, TA resection has a minimally invasive effect, less postoperative complications, high anal sphincter preservation rate, and R0 resection rate and a better prognosis. How to improve the proportion of neoadjuvant therapy and choose the appropriate cases for TA surgery is still a challenge.
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Affiliation(s)
- Zifeng Yang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.,Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
| | - Wentai Guo
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.,Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
| | - Rongkang Huang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.,Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
| | - Minhui Hu
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.,Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
| | - Huaiming Wang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.,Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
| | - Hui Wang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China.,Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Supported by National Key Clinical Discipline, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China
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7
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Spinelli A, Carvello M, Sacchi M, Bonifacio C, Bertuzzi A, Tuynman J, Montorsi M, Foppa C. Transanal minimally invasive surgery (TAMIS) for anterior rectal GIST. Tech Coloproctol 2019; 23:501-502. [PMID: 31037577 DOI: 10.1007/s10151-019-01979-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/29/2019] [Indexed: 11/26/2022]
Affiliation(s)
- A Spinelli
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.
| | - M Carvello
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - M Sacchi
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - C Bonifacio
- Division of Diagnostic Radiology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - A Bertuzzi
- Division of Medical Oncology and Hematology, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - J Tuynman
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - M Montorsi
- Division of General and Digestive Surgery, Humanitas Clinical and Research Hospital, Rozzano, Milan, Italy
| | - C Foppa
- Division of Colon and Rectal Surgery, Department of Surgery, Humanitas Clinical and Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy
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8
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Sanchez-Hidalgo JM, Duran-Martinez M, Molero-Payan R, Rufian-Peña S, Arjona-Sanchez A, Casado-Adam A, Cosano-Alvarez A, Briceño-Delgado J. Gastrointestinal stromal tumors: A multidisciplinary challenge. World J Gastroenterol 2018; 24:1925-1941. [PMID: 29760538 PMCID: PMC5949708 DOI: 10.3748/wjg.v24.i18.1925] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/27/2018] [Accepted: 05/06/2018] [Indexed: 02/06/2023] Open
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment. The arise of tyrosine kinase inhibitor has supposed a revolution in GISTs treatment being useful as adjuvant, neoadjuvant or recurrence disease treatment. That is why a multidisciplinary approach to this disease is required. The correct characterization of the tumor at diagnosis (the diagnosis of recurrences and the evaluation of the response to treatment with tyrosine kinase inhibitors) is fundamental for facing these tumors and requires specialized Endoscopist, Radiologists and Nuclear Medicine Physician. Surgery is the only potentially curative treatment for suspected resectable GIST. In the case of high risk GISTs, surgery plus adjuvant Imatinib-Mesylate for 3 years is the standard treatment. Neoadjuvant imatinib-mesylate should be considered to shrink the tumor in case of locally advanced primary or recurrence disease, unresectable or potentially resectable metastasic tumors, and potentially resectable disease in complex anatomic locations to decrease the related morbidity. In the case of Metastatic GIST under Neoadjuvant treatment, when there are complete response, stable disease or limited disease progression, complete cytoreductive surgery could be a therapeutic option if feasible.
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Affiliation(s)
- Juan Manuel Sanchez-Hidalgo
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Manuel Duran-Martinez
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Rafael Molero-Payan
- Department of Intern Medicine, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
- Lipids and Atherosclerosis Research Unit, IMIBIC/Hospital Universitario Reina Sofía/Universidad de Córdoba, Cordoba 14004, Spain
| | - Sebastian Rufian-Peña
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Alvaro Arjona-Sanchez
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Angela Casado-Adam
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Antonio Cosano-Alvarez
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
| | - Javier Briceño-Delgado
- Department of General and Digestive Surgery, Reina Sofia University Hospital, Avda. Menéndez Pidal s/n, Cordoba 14004, Spain
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9
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Eldamshety O, Metwally IH, Ghoneem E, Elkashef WF. Resection of rectal GIST using a novel technique: a report of two cases. Ecancermedicalscience 2017; 11:760. [PMID: 28900473 PMCID: PMC5574659 DOI: 10.3332/ecancer.2017.760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Indexed: 12/15/2022] Open
Abstract
Rectal gastrointestinal stromal tumours (GISTs) are uncommon tumours and usually present with large sizes. We present two cases of rectal GIST. Imatinib was used in the setting of neoadjuvant and adjuvant therapy. Both tumours were resected transanally by the transanal endoscopic operation (TEO) platform. Oncosurgeons are recommended to implement sphincter-sparing surgeries for these cases.
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Affiliation(s)
- Osama Eldamshety
- Surgical Oncology Unit, Oncology Center, Mansoura University (OCMU), Geehan Street, Mansoura, 35516, Egypt
| | - Islam H Metwally
- Surgical Oncology Unit, Oncology Center, Mansoura University (OCMU), Geehan Street, Mansoura, 35516, Egypt
| | - Elsayed Ghoneem
- Hepatology and Gastroenterology Unit, Specialized Medical Hospital, Mansoura University, Gomhoria Street, Mansoura, 35516, Egypt
| | - Wagdi F Elkashef
- Pathology Department, Faculty of Medicine, Mansoura University, Gomhoria Street, Mansoura, 35516, Egypt
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Han X, Xu J, Qiu H, Lin G. A Novel Curative Treatment Strategy for Patients with Lower Grade Rectal Gastrointestinal Stromal Tumor: Chemoreduction Combined with Transanal Endoscopic Microsurgery. J Laparoendosc Adv Surg Tech A 2017; 27:579-585. [PMID: 28358587 DOI: 10.1089/lap.2017.0051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Xianlin Han
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Jing Xu
- Peking Union Medical College, Beijing, China
| | - Huizhong Qiu
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Guole Lin
- Department of General Surgery, Peking Union Medical College Hospital, Beijing, China
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