Wu J, Jin ZD. Advancements in endoscopic resection of gastrointestinal stromal tumors: Techniques, outcomes, and perspectives. World J Gastrointest Surg 2025; 17(10): 111558 [PMID: 41178871 DOI: 10.4240/wjgs.v17.i10.111558]
Corresponding Author of This Article
Zhen-Dong Jin, Department of Gastroenterology, Changhai Hospital, Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China. zhendongjin@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2025; 17(10): 111558 Published online Oct 27, 2025. doi: 10.4240/wjgs.v17.i10.111558
Advancements in endoscopic resection of gastrointestinal stromal tumors: Techniques, outcomes, and perspectives
Jie Wu, Zhen-Dong Jin
Jie Wu, Department of Respiratory and Oncology, The 72nd Group Army Hospital of PLA, Huzhou 313000, Zhejiang Province, China
Zhen-Dong Jin, Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
Author contributions: Jie W and Jin ZD contributed equally to the conception and design of the manuscript; Jie W conducted the literature review and drafted the initial version of the manuscript; Jin ZD critically revised the manuscript for important intellectual content and supervised the entire project. Both authors approved the final version of the manuscript for submission.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhen-Dong Jin, Department of Gastroenterology, Changhai Hospital, Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China. zhendongjin@163.com
Received: July 3, 2025 Revised: July 15, 2025 Accepted: August 26, 2025 Published online: October 27, 2025 Processing time: 113 Days and 17.6 Hours
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and arise from the interstitial cells of Cajal. They predominantly affect individuals between 50 and 70 years of age and often carry malignant potential despite being frequently asymptomatic. The stomach and small intestine are the most common locations, while involvement of the esophagus, colon, or rectum is relatively rare. GISTs are often discovered incidentally during endoscopic or radiologic evaluations, and the diagnosis is confirmed through tissue biopsy and immunohistochemical staining, particularly for KIT (CD117), DOG1, and PDGFRA. In the past decade, laparoscopic resection has been considered the standard treatment for localized GISTs smaller than 5 cm. However, recent advances in endoscopic technology have led to a growing role for endoscopic resection as a safe and effective treatment option for selected nonmetastatic GISTs. Endoscopic techniques such as endoscopic submucosal dissection, endoscopic submucosal excavation, submucosal tunneling endoscopic resection, and endoscopic full-thickness resection have demonstrated favorable outcomes, including high complete resection (R0) rates, shorter hospital stays, and quicker recovery compared to traditional surgery. The selection of an appropriate resection method depends on tumor size, location, depth of invasion, and proximity to vital structures. Endoscopic ultrasound has become an essential tool for preprocedural assessment, providing detailed information on tumor characteristics and helping to guide management decisions. While endoscopic resection is a promising minimally invasive approach, it should be performed by skilled endoscopists with appropriate training due to the technical complexity and risk of complications such as bleeding or perforation. This review summarizes recent developments in endoscopic resection of GISTs, with a focus on indications, procedural safety, clinical outcomes, and recommendations for optimal patient selection and procedural planning.
Core Tip: Endoscopic resection has emerged as a promising, minimally invasive treatment for gastrointestinal stromal tumors (GISTs). Techniques like endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and endoscopic full-thickness resection have shown favorable outcomes, including high rates of complete tumor removal, reduced recovery times, and preservation of gastric function. This review explores the advancements in these techniques, highlighting their safety, efficacy, and the growing role of endoscopy in GIST management. Key factors for selecting the appropriate resection method depend on tumor size, location, and patient-specific factors.
