GASTRIC SMOOTH-MUSCLE TUMORS - DIAGNOSTIC DILEMMAS AND FACTORS AFFECTING OUTCOME

We reviewed the 46 gastric stromal tumors that were treated at our ins titution between 1958 and 1992. The most common presenting symptoms we re gastrointestinal bleeding, pain, and fatigue or malaise. The tumors ranged from 4 to 150 mm, with surgery most often being a wedge excisi on or partial gastrectomy. Abdominal computed tomography was the most specific diagnostic test obtained preoperatively. Factors associated w ith decreased survival included size greater than or equal to 8 cm (p = 0.02), more than 0-3 mitoses per 10 HPF (p < 0.001), positive margin s or unresectability (p = 0.008), and tumor pathologic grade II or mor e (p = 0.004). These tumors have an unpredictable behavior. Surgical r esection with negative margins remains the best therapy, but resection for palliation is sometimes indicated as it can be associated with pr olonged survival.