Nghe An General Friendship Hospital successfully treated a patient with gastrointestinal stromal tumor metastasizing to the liver.
Gastrointestinal stromal tumors (GIST) account for less than 1% of all gastrointestinal tumors. GIST metastases to the liver or peritoneum are not terminal and incurable.
Recently, for the first time atNghe An General Friendship Hospital, Dr. Dinh Van Chien and his team successfully performed surgery to treat a patient with a large GIST (10x11cm) in the gastric fundus with complications of gastrointestinal bleeding and liver metastasis by resecting the upper part of the stomach and restoring digestive circulation using the Double-tract technique.
The patient with GIST is Ms. Lo Thi M, 46 years old, in Ky Son district. Patient Lo Thi M was hospitalized due to gastrointestinal bleeding. Through examination, testing, endoscopy, and CT scan, doctors diagnosed gastrointestinal bleeding due to GIST of the gastric cardia, metastasis to the right liver.
After consultation, the doctors performed surgery on the patient, cutting the upper part of the stomach, restoring circulation using the Double-tract technique to prevent reflux and esophageal cancer on March 13, 2025. On the second day after treatment, the patient was able to move and eat again according to the postoperative regimen.
According to Dr. Dinh Van Chien: GIST was first reported in the world by Mazur and Clark in 1983. GIST accounts for less than 1% of all gastrointestinal tumors, the annual incidence worldwide is estimated at 10 - 20 patients/1 million people and the tumor location is mainly in the stomach.
The main treatment is surgical removal of the tumor and targeted therapy, which can be completely cured if the method is correct. The treatment indications for GIST are different from other tumors or cancers. GIST metastasis to the liver or peritoneum is not the final stage and beyond cure.
Dr. Dinh Van Chien added: The malignancy of GIST depends on the division of tumor cells. The larger the division, the higher the malignancy. GIST does not metastasize through the lymphatic system and does not invade surrounding organs. Its metastasis to other organs follows two direct and indirect routes. Direct is due to the dissemination of tumor cells into organs, from which the tumor cells develop into tumors; indirect is through the digestive tract or through the bloodstream due to tumor rupture.
GIST has no blood vessels, the growth of the tumor is due to the growth-stimulating enzyme tyrosine kinase. With these characteristics, it shows that GIST metastasis to the liver or peritoneum… is not the final stage and not beyond cure.
The choice of treatment method, drug dosage, and treatment time of GIST depends on the size, tumor cell division, and metastasis. Therefore, radical tumor resection or tumor reduction is very important in the treatment strategy when GIST has complications of bleeding, perforation, and metastasis. After surgery, combined with targeted therapy with imatinib to inhibit tyrosine kinase, liver metastases will gradually shrink and disappear. Neoadjuvant therapy can be used to reduce tumor size before surgery if there are no complications, and continue to maintain targeted therapy after surgery.
Over the years,Nghe An General Friendship HospitalOrientation for the development of special specialized techniques in the North Central region.
Dr. Dinh Van Chien and his team have successfully performed many new, specialized techniques of international stature at the hospital, including specialized techniques applied for the first time in Vietnam such as: T-Shaped technique; Delta-Shaped technique; Laparoscopic transgastric surgery; laparoscopic duodenal-jejunal anastomosis to treat superior mesenteric artery syndrome and Y-loop stenosis after biliary-enteric anastomosis; lymph node dissection technique via the portal triangle in laparoscopic gastric surgery; Double-tract technique; Double-Flap technique in upper hemi-gastric resection surgery.