Necessity for resection of gastric gastrointestinal stromal tumors ≥20 mm

Background/Aim: To evaluate whether surgical intervention was useful in patients undergoing surgery for gastric gastrointestinal stromal tumors (GISTs), for tumors ≥20 mm in size. Patients and Methods: Between August 2002 and July 2014, 138 patients with GIST underwent surgery at our Hospital, including 112 patients with gastric GISTs. The medical records of these patients were retrospectively reviewed. Results: Postoperative recurrence was observed in three patients, each having tumors with high mitotic rates and ≥21 mm in size. In 89 patients undergoing gastric wedge resection, the incidence of postoperative complications was 10.1%; 5.6% of the patients developed late sequelae, all of which were mild. The group classified as having tumors ≥21 mm in size had a higher proportion of elderly patients (p=0.0010), more complications (p=0.0152), and longer hospital stay (p=0.0589). Conclusion: To prevent recurrence, definitive diagnosis and aggressive resection while the tumor size is 20 mm or less is recommended. However, because some patients also carry surgical risks, sufficient consideration must be given to the needs of individual patients.