Long-Term Functional Outcomes of Laparoscopic Resection for Gastric Gastrointestinal Stromal Tumors (GIST)

Jeremy Dressler, Francesco Palazzo, Seth Stake, Asadulla Chaudhary, Adam Berger, Karen Chojnacki, Ernest Rosato, Michael J Pucci. Thomas Jefferson University

Introduction: Laparoscopic resection has become the treatment of choice for small to medium sized gastric GIST. While longer-term oncologic data are available, quality of life outcomes are less known.

Methods: Our IRB-approved prospectively maintained database was queried for patients who underwent laparoscopic gastric GIST resection from 2003 – 2013. Demographics, perioperative, and oncologic outcomes were collected and analyzed. Patients were contacted and asked to complete a quality of life survey consisting of the following measures: change in weight, change in appetite, early satiety, heartburn, persistent cough, chest pain, dysphagia, and regurgitation utilizing a Likert scale (1=decrease, 3=no change, 5=increase). Patients also completed the Gastrointestinal Quality of Life Index (GIQLI).

Results: A total of 69 patients were identified. Demographic and oncologic outcomes can be found in Table 1. Thirty-six patients completed the survey. Patients reported no change in any of the quality of life measures except for chest pain and regurgitation, although present in a minimal number of patients (3 and 4 patients respectively). The mean GIQLI score was 126.9 (validated score in normal healthy individuals equals 125.8).

Conclusion: In this moderate-sized cohort, laparoscopic resection of gastric GIST appears to have minimal to no effect on quality of life outcomes, with GIQLI scores comparable to healthy individuals. This technique allows for safe and durable resection of gastric GIST without significant functional sequelae.

Table 1
Patients (n) 69
Gender – male (%) 32 (46%)
Age 62 years (22 – 89)
Length of stay 4.4 days (1 – 34)
Tumor size 3.98 cm (0.5 – 11.5)
Wedge Resection 67 (97%)
Estimated Blood Loss 39 ml (10 – 500)
R0 Resection 69 (100%)
Adjuvant Gleevac 7 (10%)
Tumor Recurrence 1 (1.5%)
Mean Follow-up 39.2 months (0 – 110.6)
Dead From Disease 0 (0%)

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