Stromal sarcoma of the stomach – a report of 20 surgically treated patients

Abstract

Background: Twenty patients with gastric stromal sarcomas underwent surgery at the University Hospital of Hamburg-Eppendorf from 1979 to 1995. Symptoms were nonspecific. Exact preoperative diagnosis was difficult because of submucosal tumor growth. Operations varied from excision of the gastric wall to extended gastrectomy (pancreas, spleen, partial liver resection). Results: In 16 cases, tumor could be resected with wide margins (R0). In four cases, tumor was found at the resection line (R1). After a median follow-up of 69 months, 12 patients with R0 resections (including tumors with poor differentiation or infiltration of surrounding organs) lived tumor free, and two died due to other causes. All four patients with R1 resections died because of tumor disease within 40 months. All patients had a mean survival time of 59 months and a 5-year-survival rate of 69%. Conclusions: Our series shows that not all gastric malignancies have a dismal prognosis, but that gastric stromal sarcomas have a favorable follow-up if resected with wide margins at initial surgery.