Abstract

Objective: The study aimed to evaluate the safety and efficacy of surgical treatment of gastrointestinal stromal tumor (GIST) and combined targeted therapy.

Methods: Prospective descriptive study, including 20 patients diagnosed with GIST and indicated for surgery and combined targeted therapy when indicated at Nghe An Frienship General Hospital from January 2023 to June 2025.

Results: The average age was 58.65 years old, with more women (55%) than men (45%), 80% were ASA1. 85% of tumors were located in the stomach, 15% in the small intestine. The average size was 5.2cm. Immunohistochemical markers: 90% DOG-1 (+), 100% CD-117 (+), 100% CD-34 (+), 10% Desmin (+), 10% S100 (+), 15% had high tumor differentiation. 80% of GISTs are stage I and low grade, 15% of GISTs are stage IV, high grade, large in size, in the upper pole of the stomach, small intestine, liver and peritoneal metastases. 80% were performed by totally laparoscopic and laparoscopic transgastric, 70% had wedge resection and enucleation. 15% had double-tract and double-flap anastomosis to prevent reflux. 15% had small bowel resection and complete gastrointestinal anastomosis, of which 10% had to have the greater omentum completely resected and peritoneal debridement due to metastasis. 100% of the resection area was free of tumor cells. The average surgical time was 97.75 minutes. The average hospital stay was 6.6 days. There were no complications, adverse events, or deaths during and after surgery. Mean follow-up time was 11.57 (1.6 – 30.0) months. 15% were indicated for postoperative targeted therapy with Imatinib, 5% relapsed due to discontinuation of Imatinib treatment.

Conclusion: Surgery to treat GIST is a safe and effective method, with low rates of complications and adverse events, early recovery of health for patients, ensuring radical treatment for early-stage, low-grade GIST. For large-sized, metastatic, high-grade GIST, surgery not only helps reduce tumor size, reduce complications from the tumor, but also increases the opportunity to access and reduce the dose of targeted therapy.