Objective To investigate the effects and prognosis of surgical treatment in primary gastrointestinal stromal tumors(GIST). Methods The clinicopathological data of 73 patients with primary GIST underwent operation from April 1997 to December 2007 was retrospectively analyzed, and the prognosis was evaluated too. Results Among the 73 cases, 68 cases received complete tumor resection, among which 12 cases underwent laparoscopic operation; while palliative resection and biopsy only were carried out in the other 5 cases. There was significant difference in survival rate between the two groups (P=0.000). The 1-, 3-, 5-year survival rates of the 66 cases had been followed up was 91.0%, 78.2% and 74.1%, respectively. The malignancy risk grades of GIST was related to the survival rates on statistical analysis (P=0.002). Significant differences were found in the survival rates between the patients with very low grade, low grade and high grade maligmmey tumors (P=0.012, 0.002). Conclusions Complete tumor resection should be emphasized in primary GIST, and more attention should be paid to the initial surgical treatment Extended surgical resection is required for tumors of higher malignancy risk. The indications of laparoscopic surgery in GIST should be selected with caution for tumor complete resection.%目的 探讨原发性胃肠道间质瘤(GIST)的外科治疗方法及预后.方法 回顾性分析1997年4月至2007年12月手术切除治疗的73例原发性GIST的临床病理资料和治疗方法,并对其预后进行评价.结果 73例GIST施行肿瘤完全切除者68例(其中12例在腹腔镜下完成肿瘤切除术),行肿瘤不完全切除仅取活检者5例,两组生存率差异有统计学意义(P=0.000).66例获随访的患者1、3、5年总体生存率分别为91.0%、78.2%、74.1%,根据肿瘤直径和核分裂象计数分级的肿瘤恶性程度风险分级与术后生存率密切相关(P=0.002),极低度及低度风险组与高度风险组间生存率差异有统计学意义(P<0.05).结论 应高度重视原发性GIST的初次手术治疗,积极行肿瘤完全切除以提高疗效,对肿瘤恶性程度风险较高者需扩大切除范围,应强调腹腔镜下GIST切除术适应证的选择和肿瘤完全切除.
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