Evaluation of gastrointestinal stromal tumors for recurrence rates and patterns of long-term follow-up.

Retrospective chart review of 33 patients with gastrointestinal stromal tumors (GISTs) over the past 14 years was performed. Clinicopathologic variables were analyzed for patterns affecting tumor recurrence and need for long-term follow-up. No recurrence was found in the benign group and tumors <5 cm. In the malignant group, recurrence rate was 53 per cent with a mean follow-up of 34 months. Mean time to diagnosis of recurrence was 16 months. Eighty per cent of recurrences occurred within 2 years of surgical resection. Sixty per cent of recurrences were asymptomatic. Systematic follow-up consisted of physical examination and CT scans at 6-month intervals for 2 years after surgery. Time to diagnosis of a recurrence after surgery was 13 months for systematic follow-up and 18 months for sporadic follow-up. Mean survival was 24 months in both groups. Most recurrences occur within 2 years of surgical resection. Symptomatology does not provide early diagnosis. Patients who had systematic follow-up were diagnosed sooner with recurrence. Therefore, we recommend systematic follow-up after surgical resection of a malignant GIST to include physical examination and CT scan at 6-month intervals for up to 2 years after surgery with repeat CT scan at 3 years.