Gastrointestinal stromal tumors: A multidisciplinary challenge

Table 1 Tyrosine kinase inhibitor election based on genes mutations

Gene	Mutation	TKI. Dose
KIT	Exon 11	Imatinib-Mesylate 400 mg/d
	Exon 13
	Exon 17
	Exon 9	Imatinib-Mesylate 800 mg/d
PDGFRA	Exon 18. D842V mutation	Sunitinib 50 mg/d
		Regorafenib 160 mg/d
	Exon 12	Imatinib-Mesylate 400 mg/d
	Exon 14
	Exon 18. Non D842V mutations.
Wild-type		Sunitinib 50 mg/d
		Regorafenib 160 mg/d

Table 2 Risk stratification criteria for primary resectable gastrointestinal stromal tumor porposed by Joensuu

Risk category	Tumour size (cm)	Mitotic index (per 50 HPF)	Primary tumour site
Very low risk	≤ 2.0	≤ 5	Any
Low risk	2.1-5.0	≤ 5	Any
Intermediate risk	≤ 5.0	6-10	Gastric
	5.1-10.0	≤ 5	Gastric
High risk	Any	Any	Tumour rupture
	> 10.0	Any	Any
	Any	> 10	Any
	> 5.0	> 5	Any
	≤ 5.0	> 5	Non-gastric
	5.1-10.0	≤ 5	Non-gastric

HPF: High-power field.

Table 3 Items that pathology report should include

Pathology report items
Localization
Size
Number of foci
Tumor infiltration
Histologic subtype
Depth of tumor infiltration
Grade of dedifferentation
Mitotic rate
Ki67
Grade of necrosis
Grade of hemorrhage
Margins
Staging
Mutational study