Endoscopic or Surgical Resection for Patients with 2-5cm Gastric Gastrointestinal Stromal Tumors: A Single-Center 12-Year Experience from China

Purpose: The surgical or endoscopic resection is the current treatment modality for 2-5 cm gastric gastrointestinal stromal tumors (GISTs). However, evidence is lacking as to which treatment modality is better. Our objective is to provide a new reference for the standardization of the treatment of 2-5 cm gastric GISTs.

Patients and methods: A retrospective study was conducted on 177 patients who underwent resection for 2-5cm gastric GISTs between January 2007 and July 2019 at Xiangya Hospital of Central South University. The cases were divided into surgical group (n=118) and endoscopic group (n=59). The clinical data, pathological and genetic characteristics, short- and long-term outcomes were compared.

Results: Symptoms showed more obvious in the surgical group including abdominal pain and bleeding. In the endoscopic group, tumor size was smaller (p<0.001), and risk classification was lower (p<0.001). Patients in the endoscopic group had shorter anal exhaust time (p<0.001) and lesser hospital cost (p<0.001). However, the incidence rate of complications (25.42 vs 4.20%; p<0.001) and reoperation (22.03 vs 0.00%; p<0.001) in the endoscopic group was relatively higher than these in the surgical group. There was no significant difference in recurrence-free survival or overall survival between two groups.

Conclusion: Gastric GISTs of 2-5cm may be suitable to select laparoscopic surgery.