ABSTRACT
Some special types of stomach tumors are often encountered in clinical paractice, such as gastrointestinal stromal tumor (GIST), gastric neuroendocrine tumors (NETs), primary gastric lymphoma (PGL) and some special types of gastric cancer. Because of their special pathogenesis and pathological types with lower incidence, the choices of the treatment for these diseases are limited. This article analyzes these special types of stomach tumors in order to improve the understanding of doctors in these diseases.
Subject(s)
Humans , Gastrointestinal Stromal Tumors , Pathology , General Surgery , Lymphoma , Pathology , General Surgery , Neuroendocrine Tumors , Pathology , General Surgery , Stomach Neoplasms , Pathology , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors.</p><p><b>METHODS</b>A search of studies in PubMed and MedLine (from 1999 to 2008) was performed to assess the effect of c-kit mutation on the prognosis of gastrointestinal stromal tumors. The articles were retrieved with the entries of "gastrointestinal stromal tumors", "imatinib", "c-kit" and "mutation". A meta-analysis was performed to assess the data included.</p><p><b>RESULTS</b>A total of 15 articles were collected in this analysis. No significant differences was found in incidence of mitoses (> 5/50 HPF) between the patients with wild type c-kit (wild type group) and the ones with mutated c-kit (mutation group) (P = 0.710); tumor recurrence and metastasis rate after surgery was significant higher in the mutation group than that in wild type group (P = 0.010); as for imatinib response with different c-kit mutation types, the results showed the incidence of clinical response (complete response + partial response) was significantly higher in mutation group than that in wild type group (P = 0.009), but the imatinib resistance rate was lower in mutation group (P = 0.000); three studies provided data for imatinib resistance with c-kit second mutations, the results showed the second mutations mainly focus on exon 13, 14, 17.</p><p><b>CONCLUSIONS</b>C-kit mutation is related closely with the incidence of recurrence and metastasis in GIST after surgery. The mutations of c-kit influences the therapeutic effects of imatinib.</p>
Subject(s)
Humans , Antineoplastic Agents , Therapeutic Uses , Benzamides , Case-Control Studies , Gastrointestinal Stromal Tumors , Drug Therapy , Genetics , Imatinib Mesylate , Mutation , Piperazines , Therapeutic Uses , Prognosis , Proto-Oncogene Proteins c-kit , Genetics , Pyrimidines , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical value of preoperative portal vein embolization (PVE) for extended hepatectomy.</p><p><b>METHODS</b>A comprehensive Pubmed, Medline and Ovid database search to identify all registered literature on portal vein embolization. Meta-analysis was performed to assess the result of PVE.</p><p><b>RESULTS</b>A total of 9 literatures provided data sufficiently enough for analysis involving in 494 patients. The results showed that postoperative liver failure was higher in the non-PVE group than the PVE group, but there was no difference in postoperative mortality between the PVE and non-PVE group; in sub-category analysis of hepatocellular carcinoma and liver metastasis of colorectal cancer, there was no difference in postoperative 1, 3 and 5-year survival rate between the PVE group and non-PVE group; 1 literature about liver metastasis of colorectal cancer show there was significant difference in postoperative metastasis between the PVE and non-PVE group; several patients after PVE didn't performed hepatectomy due to disease progress.</p><p><b>CONCLUSIONS</b>PVE is a safe and effective procedure to prevent postresection liver failure due to insufficient liver remnant, but surgeon should be cautious to choose the patient for PVE.</p>