Body Mass Index impact on Extended Total Extraperitoneal Ventral Hernia Repair: a comparative study.

PURPOSE: Obesity is a risk factor for developing abdominal wall hernias and is associated with major postoperative complications, such as surgical site infection, delayed wound healing and recurrent hernia. Therefore, treating incisional hernia in this patient subgroup is a challenge. METHODS: We conducted a comparative, prospective study on patients who underwent primary ventral hernia surgery or incisional hernia surgery through the extended totally extraperitoneal pathway, with body mass indices (BMIs) ≤ 30 (no obesity) and BMI > 30 (with obesity). We collected demographic data, preoperative and intraoperative variables, complication and recurrence rate, hospital stay and follow-up as postoperative data. RESULTS: From May 2018 to December 2020, 74 patients underwent this surgery, 38 patients without obesity and 36 with obesity. The median area of the hernia defect measured by CT was 57 cm2 and 93 cm2 in patients without and with obesity, respectively (p = 0.012). The median follow-up was 16 months. One patient without obesity experienced some postoperative complication compared with four patients with obesity (p > 0.05). No patient without obesity had recurrent hernia compared with two patients with obesity (p > 0.05). CONCLUSIONS: There were statistically significant differences between patients with and without obesity in the size of the hernia defect. However, there were no significant differences in terms of complications, hospital stay, postoperative pain or relapses. Therefore, the minimally invasive completely extraperitoneal approach for patients with obesity appears to be a safe procedure despite our study limitations. Studies with longer follow-ups and a greater number of patients are needed.

[Development of animal experimental model for bacterial peritonitis]. / Desarrollo de modelo experimental animal de peritonitis bacteriana.

OBJECTIVE: The aim of the study was to develop a model of abdominal sepsis in the experimental animal. METHODS: Sprague-Dawley male rats of 5 weeks (N=39) were used. Initially, a pilot study (N = 9) was performed and distributed in 3 groups with 1cc inoculum of Escherichia coli ATCC 25922 intraperitoneally at concentrations of 10E8, 10E9 and 10E10 CFU. Subsequently, concentrations of 10E10 CFU are used in two groups of 3 rats with dilutions of 10 cc and 15 cc of distilled water respectively. Finally, a randomized trial of 24 rats was started in three treatment groups after intraperitoneal infection: Group I with physiological serum (N = 6), Group II with ceftriaxone (N = 9), Group III with ceftriaxone plus allicin (N = 9). Microbiological samples of blood and peritoneal fluid were made, as well as histopathological study of intraperitoneal organs (liver, diaphragm and peritoneum). RESULTS: Death of 100% of the rats infected with 10E10 E. coli UFC concentration with the dilution of 15 ml of distilled water and without antibiotic was oberved. The blood culture and peritoneal fluid culture was positive for the same strain in all of them. The formation of abscesses on the liver surface and polymorphonuclear infiltration in tissues were observed. CONCLUSIONS: The lethal dose of E. coli is 10E10 CFU diluted in 15 cc distilled water by intraperitoneal injection.

Laparoscopic cytoreductive surgery and HIPEC is effective regarding peritoneum tissue paclitaxel distribution.

BACKGROUND: In some patients with peritoneal carcinomatosis, we could perform the cytoreductive surgery and the HIPEC procedure by a complete laparoscopic approach to avoid morbidity. We consider that using laparoscopic approach for performing peritoneal carcinomatosis cytoreductive surgery and HIPEC with closed CO2 recirculation technique is possible and safe, with equal efficacy to conventional methods and hemodynamic complications. OBJECTIVE: Monitoring the effectiveness of the drug distribution in a laparoscopic ctoreductive and HIPEC surgery group with CO2 recirculation respect to a closed and open HIPEC group METHODS: Porcine model that included fifteen mini-pigs. Five pigs were operated with laparoscopic approach performing a pelvic and retroperitoneal lymphadenectomy. They later received a total laparoscopic closed HIPEC with CO2 recirculation (G1). Group 2 (G2): five pigs operated by an open cytoreductive surgery and closed HIPEC technique. Group 3 (G3): five animals in which an open cytoreductive surgery and an open HIPEC technique was performed. Blood and peritoneal determinations were realized after recirculation of the drug, at 60 min using chromatographic analysis. RESULTS: G1-G2: phrenic right peritoneum, p: 0.46. Phrenic left peritoneum, p: 0.46. Pelvic peritoneum, p: 0.17. Serum paclitaxel: p: 0.01. G1-G3: phrenic right peritoneum, p: 0.34. Phrenic left peritoneum, p: 0.34. Pelvic peritoneum, p: 0.17. Serum paclitaxel G1-G3, p: 0.02. CONCLUSIONS: A total laparoscopic approach for ctoreductive surgery and closed HIPEC with CO2 recirculation may be safe and feasible. In our experimental model there was no significant difference in tissue drug distribution respect the conventional techniques and there was a less toxicity because the serum drug concentration was significantly lower with laparoscopic approach respect the other groups.

Unidad Diagnóstica y pronóstica del microrna-21 en el cáncer colorrectal / Diagnostic and prognostic utility of serum microrna-21 in colorectal cancer

INTRODUCCIÓN. Los microRNAs son estructuras moleculares de 20-22 nucleótidos con actividad post-transcripional que están implicados en la carcinogénesis mediante una regulación genética post-transcripcional. Presentamos un estudio prospectivo donde se determina la expresión sérica de microRNA-21 en pacientes con diagnóstico de adenocarcinoma de colon. MATERIAL Y MÉTODOS. Estudio de cohorte prospectivo de al menos 100 pacientes con diagnóstico de adenocarcinoma de colon, y de al menos 60 pacientes con apendicitis aguda como grupo control. Se realizó el análisis de microRNA-21 sérico mediante PCR de las muestras sanguíneas de los pacientes obtenidas de forma preoperatoria. RESULTADOS. La comparación de la expresión del microRNA-21 sérico fue mayor en los pacientes con cáncer colorrectal que en los pacientes del grupo control, siendo el área bajo la curva de 0,603. En el análisis univariante, la expresión del miR- 21 se relaciona de forma estadísticamente significativa con la recidiva local (p=0,025) y con la mortalidad (p=0,029). En el análisis multivariante también se puso de manifiesto que las expresiones mayores (sobreexpresiones) de miR-21 se relacionaban con una reducción del riesgo derecidiva del 51%, mientras que dicha sobreexpresión se relacionaba con una reducción de mortalidad del 50%. CONCLUSIONES. La expresión del microRNA-21 sérico podría ser considerado como un potencial marcador diagnóstico para el cáncer colorrectal. La expresión sérica del microRNA-21 se correlaciona con la recidiva y mortalidad en el cáncer colorrectal. Nuestros resultados sugieren que el miR-21 sérico es un prometedor marcador diagnóstico y pronóstico, y pone de manifiesto su potencial utilidad clínica en el cáncer colorrectal (AU)

BACKGROUND. MicroRNAs (miRNAs) are small, noncoding RNAs that are involved in carcinogenesis through postranscriptional gene regulatory activity. Few studies have focused on the detection of miR-21 in serum rather than in tissue. The currentstudy aimed to measure serum miR-21 expression levels and to evaluate their association with the outcome of colorectal cancer (CRC). METHODS. Blood samples were collected from almost 100 CRC patients undergoing surgery with curative intent, and almost 60 control patients. The expression levels of miR-21 were measured using a quantitative reverse transcription polymerase chain reaction (qRT-PCR). RESULTS. Serum microRNA-21 expression was higher in colorectal cancer patients than in control patients, with a ROC curve of 0.603. A univariate analysis revealed that lower expression levels of serum miR-21 were associated with higher local recurrence (p=0.025) and mortality (p=0.029). A logistic regression analysis demonstrated that the relative overexpression of miR-21 (expression >1) was associated with a 51% reduction in the risk of recurrence. A Cox regression analysis identified that a relative increase in miR-21 expression (>1) was associated with a 50% reduction in the risk of mortality. CONCLUSIONS. Serum microRNA-21 expression could be considered as a potential diagnostic marker for colorectal cancer. The expression level of serum miR-21 correlates with the recurrence and mortality of CRC patients. Our results suggest that circulating serum miR-21 is a promising diagnostic and prognostic tumour marker, and they highlight the potential clinical utility of miR-21 in colorectal cancer (AU)

[Serum microRNA-21 usefulness in inflammatory pathology of the colon]. / Utilidad de la determinación sérica de microRNA-21 en la enfermedad inflamatoria del colon.

BACKGROUND: MicroRNAs are 20-22 nucleotide molecular structures with post-transcriptional activity that are involved in the immune response, as well as in the inflammatory pathways of different cells and tissues. AIMS: We present herein a prospective study in which serum microRNA-21 expression was determined in patients diagnosed with acute appendicitis as a model of bowel inflammation. MATERIAL AND METHODS: A prospective cohort study of patients diagnosed with acute appendicitis was conducted. Serum microRNA-21 was analyzed through the PCR of blood samples taken from the patients prior to surgery. MicroRNA-21 values were compared with the analytic variables (leukocytes, hemoglobin, hematocrit, platelets, prothrombin activity, glucose, urea, and creatinine) and the anatomopathologic variables (normal appendix, phlegmonous, gangrenous, and perforated acute appendicitis). RESULTS: A total of 60 patients with acute appendicitis diagnosis were consecutively included in the study from June to October 2009. Sixty-six percent of the patients were men (40 men and 20 women), with a mean age of 26.2±14.8 years. The mean absolute level of microRNA-21 was 24.8±0.93, whereas the mean microRNA-21 gene expression was 1.04±0.28. No correlation between the analytic and anatomopathologic parameters evaluated was observed (P=.47). CONCLUSIONS: It is necessary to continue to search for the most appropriate microRNAs, so that their determination in serum can lead to greater precision in establishing the diagnosis and outcome of inflammatory disorders of the bowel.

Carcinogénesis del cáncer colorrectal / Colorectal cancer carcinogenesis

El cáncer colorrectal representó en el año 2008 el tercer tumor más diagnosticado en España, siendo la segunda neoplasia que causó más fallecimientos. El conocimiento del proceso carcinogenético de este tipo de enfermedad permitirá el descubrimiento de nuevas terapéuticas que conlleven menores tasas de incidencia y mortalidad. El continuo avance en la enfermedad tumoral hace que esta revisión sea una puesta al día en el conocimiento de la carcinogénesis del cáncer colorrectal (AU)

In 2008, colorectal cancer represented the third most commonly diagnosed tumor in Spain, and the second tumor that caused ore deaths. Knowledge of the carcinogenetic process of this disease will allow the discovery of new therapies involving lower rates of incidence and mortality. The continuous progress in tumor disease makes this review an update on the knowledge of colorectal cancer carcinogenesis (AU)

Biological behavior due to cell proliferation markers of gastrointestinal stromal tumors.

BACKGROUND/AIMS: The mitotic index and tumor size are currently the main prognostic indicators of gastrointestinal stromal tumors (GIST). The purpose of this study is to investigate the expression of different immunohistochemical markers and their relation to mortality and relapse, and especially concerning high-risk tumors. METHODOLOGY: We did a retrospective study of 68 patients who underwent surgery from 1997 to 2007 with a diagnostic of gastrointestinal stromal tumor. RESULTS: The median follow-up period was 29 months. Relapse and mortality rates were 35.3% (24 cases) and 41.2% (28 cases), respectively. The mitotic index was related to p53 and the cellular proliferation index -Ki67- (p = 0.006 and p = 0.003, respectively). Considering both high and intermediate-risk neoplasms, a significant relation to Ki67 was obtained (p = 0.008). Relapse was related to the mitotic index (p = 0.032) and Ki67 (p = 0.024). Concerning mortality, statistically significant results were obtained with necrosis variables (p = 0.02), mitotic index (p = 0.013), p53 (p = 0.024) and Ki67 (p = 0.033). CONCLUSIONS: Ki67 could be considered a prognostic marker for both relapse and mortality. Concerning high risk GIST, the usefulness the p53 protein and Ki67 nuclear antigen markers was also evident concerning relapse and mortality.

[Quality indicators in bariatric surgery: weight loss valoration]. / Indicadores de calidad en cirugía bariátrica: Valoración de la pérdida de peso.

The medical management of MO may be effective in the short and intermediate terms, although it usually fails then leading to surgical management. Our goal is to assess Capella's surgical technique by means of quality indicators including weight loss. The present work has been performed with surgical MO patients at the 12 de Octubre University Hospital during 2000-2001, and registering the follow-up checkups for the period 2000-2001/2003-2004. We reviewed the clinical charts of 23 patients. The average Body Mass Index (BMI) was 52.24 +/- 10.07 kg/m(2), (range, 41-74.41). When compiling the statistical results, we observed statistically significant post-surgical decreases with no differences whether the PEIMCP outcome was excellent (>or= 65%), fair (= 50-65%) or failure (or= 60 kg/m(2).

Indicadores de calidad en cirugía bariátrica. Valoración de la pérdida de peso / Quality indicators in bariatric surgery. Weight loss valoration

El tratamiento médico de la OM puede resultar efectivo a corto y medio plazo, pero generalmente termina por fracasar, recurriéndose entonces al tratamiento quirúrgico. Nuestro objetivo es evaluar la técnica quirúrgica de Capella mediante unos indicadores de calidad entre los que se encuentra la valoración de la pérdida de peso. El presente estudio se ha llevado a cabo en los pacientes intervenidos quirúrgicamente de OM en el Hospital Universitario 12 de Octubre durante el bienio 2000-2001, recogiéndose los controles evolutivos del trienio 2000-2001/2003-2004. Se analizaron las historias de 23 pacientes. El Índice de Masa Corporal (IMC) medio fue de 52,24 ± 10,07 kg/m2, (rango, 41-74,41). Compendiando los resultados estadísticos se constataron descensos postoperatorios estadísticamente significativos, no percibiéndose diferencias para estas variables en función de si el resultado del PEIMCP fue excelente (≥ 65%), bueno (= 50-65%) o fracaso (≤ 50%), en los siguientes parámetros: IMC (p ≤ 0,001). Comorbilidades (p ≤ 0,001). Hemoglobinemia (p ≤ 0,005). Glucemia (p ≤ 0,001). Triglicéridemia (p ≤ 0,001). Colesterolemia Total (p ≤ 0,001). Sideremia (p ≤ 0,001). Cianocobalamina Sérica (p ≤ 0,001). Sin poder demostrarse alteraciones estadísticamente significativas en los parámetros restantes. Pero con la presunción de que la ausencia de evidencia no significa evidencia de ausencia; es decir, los resultados han sido obtenidos para un tamaño muestral pequeño (N = 23), por lo que no se pueden considerar necesariamente concluyentes. Considerando el porcentaje del exceso del índice de masa corporal perdida como uno de los índices de calidad en cirugía bariátrica, podríamos afirmar que el by-pass gástrico de Capella resulta eficiente en los pacientes obesos con un IMC ≤ 50 kg/m2, dudosamente efectivo en pacientes con un IMC comprendido entre los 50-60 kg/m2 e ineficaz en los pacientes superobesos con un IMC ≥ 60 kg/m2 (AU)

The medical management of MO may be effective in the short and intermediate terms, although it usually fails then leading to surgical management. Our goal is to assess Capella's surgical technique by means of quality indicators including weight loss. The present work has been performed with surgical MO patients at the 12 de Octubre University Hospital during 2000-2001, and registering the follow-up checkups for the period 2000-2001/2003-2004. We reviewed the clinical charts of 23 patients. The average Body Mass Index (BMI) was 52.24 ± 10.07 kg/m2, (range, 41-74.41). When compiling the statistical results, we observed statistically significant post-surgical decreases with no differences whether the PEIMCP outcome was excellent (≥ 65%), fair (= 50-65%) or failure (≤ 50%) in the following parameters: BMI (p ≤ 0.001); Comorbidities (p ≤ 0.001); Hemoglobinemia (p ≤ 0.005); Glycemia (p ≤ 0.001); Triglyceridemia (p ≤ 0.001); Total cholesterolemia (p ≤ 0.001); Sideraemia (p ≤ 0.001); and serum cianocobalamine (p ≤ 0.001). We could not demonstrate statistically significant changes in the remaining parameters. However, under the presumption that the lack of evidence does not mean the evidence of the absence, that is to say, the results have been obtained from a small sample (N = 23) so that they may not be considered definitely conclusive. Considering the percentage of the loss of Body Mass Index excess as one of the quality indexes in bariatric surgery, we may state that Capella's gastric by-pass is efficient in obese patients with BMI ≤ 50 kg/m2, doubtfully effective in patients with BMI 50-60 kg/m2, and ineffective in super obese patients with BMI ≥ 60 kg/m2 (AU)

Determinación inmunohistoquímica y utilidad pronóstica del receptor del factor de crecimiento epidérmico en los tumores estromales gastrointestinales / No disponible

Introducción: el receptor del factor de crecimiento epidérmico,EGFR(HER-1), es un receptor de tirosina quinasas cuya activaciónpermite un aumento de la proliferación celular, angiogénesis,proceso metastásico y disminución de la apoptosis celular. Nuestroobjetivo es conocer el valor pronóstico de la inmunotinción deEGFR en tumores estromales gastrointestinales (GIST).Pacientes y método: estudio retrospectivo que incluye todoslos GIST intervenidos quirúrgicamente entre 1995-2007 en elServicio de Cirugía General y del Aparato Digestivo del HospitalGeneral de Ciudad Real. Variables clínicas: edad, sexo, clínica,mortalidad, recidiva. Variables patológicas: a) macroscópicas: localización,diámetro; b) microscópicas: necrosis tumoral, índicemitótico, tipo celular; y c) inmunohistoquímicas: vimentina (V9,Dako A/s); actina del músculo liso (HHF-35, Biogenex); CD34(QBEND/10); S100 (Policlonal Dako A/S); CD117 (c-kit Rabbit,antihuman polyclonal antibody, 1:600); PDGFR-alfa (Rabbitpolyclonal antibody, 1:50, Sta. Cruz Biotechnology). Variablesmoleculares pronósticas: P-53, PAb240 (DakoCytomation), 1:75,Ki-67, clona MIB1 (Dako), 1:120 y EGFR pharmDx™ Dako Autostainer(Dako, Dinamarca). Criterios de malignidad: criteriosde Fletcher.Resultados: entre 1995 y 2007, 35 GIST, fueron intervenidosquirúrgicamente en nuestro Servicio. Edad media: 61,11 ±11,02, siendo mujeres en el 62,9% de los casos. Debutaron conhemorragia digestiva en un 40%. La mediana de seguimiento fuede 28 meses (3-133). La mortalidad fue de 54,3%, con recidivadel 40%. Variables morfológicas: la localización más frecuente fuegástrica, 51,4% (18). Existió necrosis tumoral en un 57,1%, 20.El patrón celular fue fusocelular en un 57,1%, y epitelioide en un14,3%. El diámetro máximo fue de 9,58 ± 6,29. El índice mitóticopor 50 campos de gran aumento fue de 13,44 ± 16,08. En un51,45%, 18, fueron neoplasias de alto riesgo. Valores inmunohistoquímicos:CD117+, 85,7%. PDGFRA+, 85,7%. CD34+,77,1%. EGFR+, 62,9%. S100+, 34,3%. Actina+, 20%. Vimentina+,100%. p53+, 40%. ki67+, 10,71 ± 10,82. La expresión deEGFR no se relacionó con la recidiva y/o mortalidad del enfermo p = 0,156, y p = 0,332, respectivamente. El índice mitótico serelacionó con la mortalidad del enfermo, p = 0,02, y recidiva neoplásica,p = 0,013.Conclusión: en nuestra muestra no existió relación entre lainmunotinción de EGFR y el pronóstico del tumor estromal gastrointestinal

Introduction: the epidermal growth factor receptor, EGFR(HER-1), is a tyrosine kinase receptor. EGFR activation plays animportant role in increased cell proliferation, angiogenesis, anddecreased apoptosis. Our objective was to study EGFR immunoexpressionin GIST, as well as its prognostic value.Patients and method: a retrospective study that included allpatients operated on with a histologic diagnosis of GIST at Departmentof Surgery, Hospital General, Ciudad Real, between1995 and 2007. Clinical features: age, sex, manifestations, mortality,recurrence. Pathological features: origin, size, tumoralnecrosis, mitotic index, cell type. Immunohistochemical features:vimentin, (V9, Dako A/s); smooth muscle actin (HHF-35,Biogenex); CD34 (QBEND/10); S100 (Policlonal Dako A/S),CD117, (c-kit Rabbit, antihuman polyclonal antibody, 1:600);PDGFR-alfa (Rabbit polyclonal antibody, 1:50, Sta. Cruz Biotechnology).Prognostic molecular features: P-53, PAb240 (DakoCytomation)1:75; Ki-67, clona MIB1 (Dako), 1:120 y (EGFR)pharmDx™ Dako Autostainer (Dako, Denmark). Malignancycritera: Fletcher's critera.Results: from 1995 to 2007, 35 GISTs were resected in ourDepartment. Mean age: 61.11 ± 11.02, with a female predominanceof 62.9%. Initial clinical manifestation included digestivehemorrhage in 40%. Median follow-up was 28 months (3-133).Mortality was 54.3%, and recurrence rate was 40%. The mostfrequent origin was the stomach, 51.4%, (18). There was tumornecrosis in 57.1% (20). There were spindle-like cells in 57.1%,and epithelioid cells in 14.3%. Mean size was 9.58 ± 6.29. Mitoticindex per 50 high-power fields was 13.44 ± 16.08; 51.45%(18) were high-risk tumors. Immunohistochemical expression:CD117+, 85.7%. PDGFRA+, 85.7%. CD34+, 77.1%. EGFR+,62.9%. S100+, 34.3%. Actin+, 20%. Vimentin+, 100%. p53+,40%. ki67+, 10.71 ± 10.82. There was no correlation betweenEGFR expression and recurrence and/or mortality, p = 0.156and p = 0.332, respectively. Mitosis index related to mortality, p= 0.02, and recurrence, p = 0.013. Conclusion: in our study there was no relation betweenEGFR immunohistochemical expression and the prognosis of GIST (AU)

Hemorragia digestiva secundaria a lipoma duodenal / No disponible

No disponible

Íleo biliar subsecuente a una fístula colecistoduodenal (síndrome de Bouveret) / No disponible

No disponible

Cirugía y testigos de Jehová. Respuesta de los autores / Surgery and Jehovah’s witnesses. Authors’ reply

No disponible

[Immunohistochemical expression of epidermal growth factor and its prognostic value for gastrointestinal stromal tumors]. / Determinación inmunohistoquímica y utilidad pronóstica del receptor del factor de crecimiento epidérmico en los tumores estromales gastrointestinales.

INTRODUCTION: The epidermal growth factor receptor, EGFR (HER-1), is a tyrosine kinase receptor. EGFR activation plays an important role in increased cell proliferation, angiogenesis, and decreased apoptosis. Our objective was to study EGFR immuno-expression in GIST, as well as its prognostic value. PATIENTS AND METHOD: A retrospective study that included all patients operated on with a histologic diagnosis of GIST at Department of Surgery, Hospital General, Ciudad Real, between 1995 and 2007. CLINICAL FEATURES: age, sex, manifestations, mortality, recurrence. Pathological features: origin, size, tumoral necrosis, mitotic index, cell type. Immunohistochemical features: vimentin, (V9, Dako A/s); smooth muscle actin (HHF-35, Biogenex); CD34 (QBEND/10); S100 (Policlonal Dako A/S), CD117, (c-kit Rabbit, antihuman polyclonal antibody, 1:600); PDGFR-alfa (Rabbit polyclonal antibody, 1:50, Sta. Cruz Biotechnology). Prognostic molecular features: P-53, PAb240 (DakoCytomation) 1:75; Ki-67, clona MIBI (Dako, Denmark). Malignancy criteria: Fletcher's criteria. RESULTS: From 1995 to 2007, 35 GISTs were resected in our Department. Mean age: 61.11 +/- 11.02, with a female predominance of 62.9%. Initial clinical manifestation included digestive hemorrhage in 40%. Median follow-up was 28 months (3-133). Mortality was 54.3%, and recurrence rate was 40%. The most frequent origin was the stomach, 51.4%, (18). There was tumor necrosis in 57.1% (20). There were spindle-like cells in 57.1%, and epithelioid cells in 14.3%. Mean size was 9.58 +/- 6.29. Mitotic index per 50 high-power fields was 13.44 +/- 16.08; 51.45% (18) were high-risk tumors. Immunohistochemical expression: CD117+, 85.7%. PDGFRA+, 85.7%. CD34+, 77.1%. EGFR+, 62.9%. S100+, 34.3%. Actin+, 20%. Vimentin+, 100%. p53+, 40%. ki67+, 10.71 +/- 10.82. There was no correlation between EGFR expression and recurrence and/ or mortality, p = 0.156 and p = 0.332, respectively. Mitosis index related to mortality, p = 0.02, and recurrence, p = 0.013. CONCLUSION: In our study there was no relation between EGFR immunohistochemical expression and the prognosis of GIST.