Gastrointestinal stromal tumours (GISTs): French Intergroup Clinical Practice Guidelines for diagnosis, treatments and follow-up (SNFGE, FFCD, GERCOR, UNICANCER, SFCD, SFED, SFRO).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Landi Bruno, Blay Jean-Yves, Bonvalot Sylvie, Brasseur Mathilde, Coindre Jean Michel, Emile Jean François, Hautefeuille Vincent, Honore Charles, Lartigau Eric, Mantion Georges, Pracht Marc, Le Cesne Axel, Ducreux Michel, Bouche Olivier, «Thésaurus National de Cancérologie Digestive (TNCD)» (Fédération Francophone de Cancérologie Digestive (FFCD), Fédération Nationale de Centres de Lutte Contre les Cancers (UNICANCER), Groupe Coopérateur Multidisciplinaire en Oncologie (GERCOR), Société Française de Chirurgie Digestive (SFCD), Société Française de Radiothérapie Oncologique (SFRO), Société Française d’Endoscopie Digestive (SFED), Société Nationale Française de Gastroentérologie (SNFGE)
Аннотация
DESIGN: This collaborative work summarizes clinical practice recommendations (guidelines) on the management of GISTs. It is based on recent literature review, ESMO recommendations and expert opinions.
RESULTS: The diagnosis of GIST is based on histological examination and immunohistochemistry with markers KIT and DOG-1. Each case must be discussed within a multidisciplinary team. Complete surgical resection tumour, avoiding peroperative perforation, is the potentially curative treatment of localized GISTs. The estimation of the recurrence risk is essential, or adjuvant treatment,and follow-up adaptation. Genotyping (KIT and PDGFRA) of all but very low-risk GISTs is recommended. The nature of mutation has a prognostic value and predictive influence on drug efficacy. Imatinib, a tyrosine-kinase inhibitor, is the standard adjuvant treatment after R0 resection of a GIST with a high risk of recurrence, and the first line therapy for advanced GISTs. Suninitib and regorafenib are respectively the second- and third-line standard treatments for advanced GISTs.
CONCLUSION: Guidelines for management of GISTs are continuously evolving and need to be regularly updated. This constant progress is made possible through clinical and translational research.