DIAGNOSIS AND SURGICAL-TREATMENT OF GASTRIC SARCOMA

Gastric sarcoma is rare, accounting for no more than 1-3% of all gastr ic malignancies. Approximately one half of all gastrointestinal sarcom as develop in the stomach. Upper GI series and endoscopy can identify the presence of a gastric lesion, but endoscopic biopsy usually fails to establish a histological diagnosis. The vast majority of gastric sa rcomas are of myogenic origin. It may be difficult to determine the be nign or malignant character of a stromal tumor, even if intraoperative frozen section is performed. Surgical treatment should be aimed at co mplete removal of the tumor with at least a 2-cm margin. Systematic ly mphadenectomy is not indicated. Tumor grading and size are independent predictors of prognosis. Tumor biology varies widely and 5-year recur rence-free survival has been reported from 20-68%. Chemotherapy or rad iotherapy in an adjuvant setting or for treatment of recurrence are la rgely ineffective.