Surgery for gastrointestinal stromal tumors (GIST)
The exact treatment of gastrointestinal stromal tumors (GIST) will depend on the size and properties of the tumor: does it experience rapid growth, and has it spread through the body?
Surgery for small GISTs
Small gastrointestinal stromal tumors that have not spread through the body can be treated by surgery, sometimes in combination with targeted therapy close to the date of the surgery. Most GISTs are relatively small. As long as the tumor does not show any aggressive properties, surgery will be sufficient.
GIST removal surgery will usually be laparoscopic; a keyhole surgery. Your surgeon will make several small incisions through which he or she will remove the tumor and the part of the stomach or intestine to which the tumor has attached itself. Most people won’t have to stay at the hospital for too long after this surgery, as recovery tends to be quick.
Surgery and targeted therapy for larger gastrointestinal stromal tumors
If the tumor is larger, or if it developed in a complex location, you may need open abdominal surgery. This means that a larger incision will be needed in order to safely remove the tumor. GISTs can be fragile tumors, so we will have to be extra careful that nnothing breaks off during the surgery. Larger tumors may attach to the surrounding tissue and organs, which would require the removal of (parts of) other organs - the specifics of your surgery will depend on your personal situation.
Once the tumor grows or shows aggressive characteristics and has the proper molecular properties, we can treat you with targeted therapy for a period of three years. This treatment will be delivered close to the date of your surgery in order to lower the risk of GIST recurrence elsewhere in the body. The treatment may also shrink the tumor, which will make the surgery easier and less invasive. Your surgery will be scheduled between 6 and 12 months after you start your medication. The exact time will depend on your response to the treatment. If necessary, the targeted treatment can be continued after surgery for 3 years.
Some patients will receive surgery followed by 3 years of targeted therapy. This treatment plan is personalized to the patient’s needs and will be chosen in collaboration with the multidisciplinary treatment team and the patient.
Surgery for metastatic gastrointestinal stromal tumors
GISTs that have spread through the body are difficult to treat through surgery, so we rarely operate on these types of tumors. The decision to schedule surgery for these metastatic GISTs is always made on a case-by-case basis and will depend on many other factors, as well as the patient’s response to the medication. The specifics of your surgery will depend on your personal situation and will be discussed with you in person.