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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2014; 35(04): 244-248
DOI: 10.4103/0971-5851.144983
POSITION PAPER

Indian Council of Medical Research consensus document for the management of gastrointestinal stromal tumors

Shailesh V. Shrikhande
Department of Surgical Oncology, Narayana Health, Bangalore, India
,
Bhawna Sirohi
Department of Medical Oncology, Narayana Health, Bangalore, India
,
Savio G. Barreto
Institute of Digestive and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Raju T. Chacko
Christian Medical College, Vellore, Tamil Nadu, India
,
Purvish M. Parikh
Indian Cancer Society, Parel, Mumbai, Maharashtra, India
,
Jeremy Pautu
Mizoram Sate Cancer Institute, Aizwal, Mizoram, India
,
Supreeta Arya
Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
,
Prachi Patil
Department of DDCN, Tata Memorial Centre, Mumbai, Maharashtra, India
,
Srinivas C. Chilukuri
Department of Radiation Oncology, Yashoda Hospital, Hyderabad, Andhra Pradesh, India
,
B Ganesh
Department of Epidemiology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
,
Tanvir Kaur
Indian Council of Medical Research, All India Institute of Medical Sciences, New Delhi, India
,
Deepak Shankar Shukla
Indian Council of Medical Research, All India Institute of Medical Sciences, New Delhi, India
,
Goura Rath
Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
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E X E C U T I V E S U M M A R Y

This consensus statement was produced along with the gastric cancer discussions as stomach is the most common site for gastrointestinal stromal tumor (GIST). The recommendations apply to treatment of GIST.Evaluation of a patient with newly diagnosed GIST should include essential tests: A standard white light endoscopy with 6-8 biopsies (c-KIT testing on immunohistochemistry) from the tumor for confirmation of the diagnosis, a computed tomography (CT) scan (multi-detector or helical) of the abdomen and pelvis for staging with a CT chest or chest X-ray, and complete blood counts, renal function tests and liver function tests. Endoscopic ultrasonography (EUS)/magnetic resonance imaging (MRI)/positron emission tomography (PET)-CT are not recommended for all patients.For localized and resectable disease, surgery is recommended. The need for adjuvant treatment with imatinib would be guided by the risk stratification on the histopathological analysis of the resected specimen.For localized but borderline resectable tumors, upfront surgery may be considered only if complications due to the tumor are present such as major bleeding or gastric outlet obstruction. In all other patients, neoadjuvant imatinib should be considered to downstage the disease followed by surgery (with a curative intent, if feasible) in those with stable or partial response. This may be followed by adjuvant imatinib. In those patients with a poor response, further imatinib with dose escalation or sunitinib may be considered.Patients with metastatic disease must be assessed for treatment with imatinib as first-line therapy followed by sunitinib as second-line therapy versus best supportive care on an individual basis.

Keywords

Diagnosis - GIST - guidelines - ICMR - treatment


Publication History

Article published online:
19 July 2021

© 2014. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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