Gastric Stromal Tumor Surgery: Understanding the Options

When it comes to treating gastric stromal tumors, the surgical approach differs significantly from that of gastric cancer. Unlike gastric cancer, which typically requires extensive lymph node dissection and removal of at least two-thirds of the stomach, gastric stromal tumors are managed with a focus on complete tumor resection. The choice of surgical technique largely depends on the size and location of the tumor.

For smaller gastric stromal tumors, a localized resection may be sufficient to remove the lesion completely. However, if the tumor is large, a more extensive procedure similar to gastric cancer surgery may be necessary. This could involve removing up to two-thirds of the stomach along with regional lymph node dissection to ensure all cancerous cells are eliminated.

After surgery, the need for adjuvant therapy is determined by several factors including tumor size, mitotic count, and pathological findings. Patients with tumors smaller than 2 cm and low mitotic activity generally do not require additional targeted therapy. On the other hand, if the tumor measures between 5–10 cm and exhibits more than 10 mitotic figures per high-power field, postoperative treatment with imatinib (Gleevec) is often recommended to reduce the risk of recurrence. This approach helps manage intermediate- to high-risk cases effectively.

Understanding these surgical and postoperative treatment strategies is essential for patients and caregivers navigating a diagnosis of gastric stromal tumor. Each case is unique, and decisions should be made in close consultation with a multidisciplinary medical team.