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Advances in the Diagnosis and Treatment of Gastrointestinal Stromal Tumors
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Advances in the Diagnosis and Treatment of Gastrointestinal Stromal Tumors

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 1391

Special Issue Editors

Dr. Dimitrios Balalis

E-Mail Website
Guest Editor
1. 4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
2. Department of Surgical Oncology, Athens Medical Center, Athens, Greece
Interests: surgical oncology; hepatobiliary and pancreas surgery; sarcoma
Special Issues, Collections and Topics in MDPI journals
Dr. Stefania Kokkali

E-Mail Website
Guest Editor
Department of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: medical oncology; gastrointestinal stromal tumors
Prof. Dr. Nikolaos Vassos

E-Mail Website
Guest Editor
MD, PhD, FEBS (SurgOnc), MHBA, Medical Faculty Mannheim, Mannheim University Medical Center, University of Heidelberg, 68167 Mannheim, Germany
Interests: surgical oncology; sarcoma; gastrointestinal stromal tumors; desmoid; melanoma; gastrointestinal cancer; digestive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent decades, there have been several developments in biology of gastrointestinal stromal tumors (GIST) that enhance new diagnostic and therapeutic strategies. Surgery remains the cornerstone treatment in localized disease and can also be clinically relevant in the metastatic setting. However, the introduction of tyrosine kinase inhibitors (TKIs) was revolutionary in treating GIST patients, as it established treatment algorithms for patients with advanced GIST.

Novel therapeutic strategies focus on overcoming the heterogeneity of KIT or platelet-derived growth factor receptor (PDGFRA) secondary mutations and providing more potent inhibition of specific challenging mutations. Recently, new TKIs have been approved in patients harboring PDGFRA exon 18 D842V mutations. Additionally, there are several experimental therapies under investigation that could advance individualized patient care. Therapies based on the significant role of angiogenesis, immunology, and neural origin in the GIST biology could become a valuable enhancement of currently implemented treatment schemes. Generating miRNA networks that would predict miRNA regulatory functions is a promising approach that might help in better selection of potential biomarkers and therapeutical targets in GIST.

The correct combination and sequence of targeted agents and surgical procedures improves outcomes for patients with GIST and should be discussed individually within multidisciplinary expert teams.

In this Special Issue, we would like to invite original clinical and basic research, meta-analyses, and state-of-the-art reviews related to advances in the diagnosis and treatment of gastrointestinal stromal tumors.

We will be grateful to receive your submissions.

Dr. Dimitrios Balalis
Dr. Stefania Kokkali
Prof. Dr. Nikolaos Vassos
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • GIST
  • surgery
  • mutation
  • targeted agent
  • tyrosine kinase inhibitor
  • biomarker

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Published Papers (1 paper)

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Research

16 pages, 689 KB  
Article
The Role of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Peritoneal GIST-Induced Sarcomatosis (GISTosis)
by John Spiliotis, Nikolaos Kopanakis, Athanasios Rogdakis, George Peppas, Aphrodite Fotiadou, Kyriacos Evangelou and Nikolaos Vassos
J. Clin. Med. 2026, 15(2), 742; https://doi.org/10.3390/jcm15020742 - 16 Jan 2026
Viewed by 615
Abstract
Background: The introduction of tyrosine kinase inhibitors has revolutionised the treatment of gastrointestinal stromal tumours (GISTs), yet the role of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal GISTosis remains controversial. Methods: A retrospective analysis was conducted on patients with peritoneal [...] Read more.
Background: The introduction of tyrosine kinase inhibitors has revolutionised the treatment of gastrointestinal stromal tumours (GISTs), yet the role of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in peritoneal GISTosis remains controversial. Methods: A retrospective analysis was conducted on patients with peritoneal GISTosis who underwent CRS plus HIPEC in an 18-year period. We analysed the clinicopathological characteristics and evaluated the perioperative and long-term outcomes based on the extent of disease (peritoneal cancer index, PCI), the resection (completeness of cytoreduction score) and the IM-administration. The survival factors were also analysed and the Kaplan–Meier estimator to model and estimate overall (OS) and progression-free survival (PFS). The median follow-up period was 72 months (range, 12–146). Results: A total of 25 patients (M:F = 15:10) with a median age of 57 years (range, 32–69) underwent CRS with HIPEC for peritoneal GIST metastases, detected either synchronously (n = 11) or metachronously (n = 14). The media PCI score was 9 (range, 4–20) and complete cytoreduction was achieved in 80%. Grade III complications were observed in two patients, whereas there was no postoperative mortality. Neoadjuvant imatinib-mesylate (IM) therapy was administered in 60% of patients who detected with metachronous metastases (n = 8/14), whereas adjuvant IM therapy was administered in 19 of 25 patients. Median OS was 62 months (95% CI = 22.8–101.2). Median OS and DFS for patients with PCI scores ≤ 10 were significantly longer compared to those with PCI scores > 10 (p = 0.009 and p = 0.024, respectively). Patients with CC scores of 0–1 had a significantly longer OS compared to those with CC scores of 2 (p = 0.005) and 3 (p = 0.002) and longer PFS compared to those with CC scores of 3 (p = 0.005). The need for imatinib did not significantly impact OS (p = 0.240) or PFS (p = 0.243). Conclusions: CRS combined with HIPEC shows promising results in peritoneal GISTosis, especially in patients with lower PCI and CC scores. Until larger studies validate its safety and efficacy, it should be primarily performed in expert hands in specialised peritoneal surface oncology centres. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Gastrointestinal Stromal Tumors)
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