Gastrointestinal_stromal_tumour_a_review_of_literature

Gastrointestinal stromal tumours (GIST) are the most common of the rare non-epithelial neoplasms of the gastrointestinal tract, accounting for 0.1–3% of gastrointestinal malignancies. They were considered smooth muscle sarcomas until being recognized as a distinct disease in the 1990s. Interstitial cell of Cajal (ICC), also called gastrointestinal pacemaker cell, regulates the gastrointestinal tract peristalsis and is proposed to be the cell of origin for GIST. [1] The majority (95%) of GISTs are driven by gain-of-function mutations in receptor tyrosine kinases that are encoded by the proto-oncogene KIT. Various clinical trials have demonstrated the efficacy of tyrosine kinase inhibitors (TKIs) in the treatment of GISTs, including metastatic disease. The leading treatment for GIST cases remains surgical resection. Standard first-line therapy for inoperable, metastatic or recurrent disease is the tyrosine-kinase inhibitor Imatinib. With the development of laparoscopic techniques and instruments, laparoscopy has rapidly become a preferred approach, especially for gGISTs. The indication for a laparoscopic procedure depends on the location, shape and size of the gGIST. The latest National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) Guidelines suggest that a laparoscopic resection may be considered for gGISTs in favourable anatomic locations (such as the greater curvature or anterior wall of the stomach) and discourage its use in patients who have large tumours. We have done a non-systematic review of the literature of GISTs, focusing on the use of laparoscopic treatment and all the chemotherapeutic drugs available nowadays. The purpose of this work is to review the past year's literature to provide comprehensive information to researchers and physicians regarding the epidemiology, diagnosis, and treatment of GISTs, enabling clinicians to best select the diagnostic and treatment approaches to GIST.