Welche Form der Nachsorge ist bei Patienten mit R0-resezierten gastrointestinalen Stromatumoren (GIST) sinnvoll?

UNLABELLED: Gastrointestinal stromal tumours are topical because of their uncertain biological behaviour and the potential of treatment with imatinib. In the following study we have examined which pattern of follow-up is both appropriate for detecting recurrences and cost-effective. PATIENTS AND METHODS: Between July 1997 and February 2004 we treated 43 patients diagnosed with a GIST. Patients with high risk (HR), intermediate risk (IR), or overtly malignant (OM) tumours were followed-up regularly. In 2004 we screened all patients independent of their risk of malignant disease with an ultrasound scan and endoscopy followed by endosonography. Further diagnostic procedures were carried out if necessary. RESULTS: Overall, we diagnosed recurrences in five out of 33 patients at risk (two in patients with OM, one in a patient with HR, and 2 in patients with IR according to the NIH criteria). The time period between resection of the primary tumour and recurrence ranged from 4.5 to 33 months. One of the patients with a recurrence was seen before the imatinib era, the other four were treated with imatinib mesylate. CONCLUSION: In our experience, regular follow-up should be restricted to patients with OM, HR, and IR GIST. We suggest that patients are initially seen in six months intervals for two years and annually for another three years thereafter.