Researchers discovered that endoscopic treatment was a viable therapeutic option for esophageal gastrointestinal stromal tumors (GISTs), according to a new study published in the Scandinavian Journal of Gastroenterology.

GISTs are rare mesenchymal tumors of the GI tract, with esophageal GISTs accounting for less than 1% of cases. Complete resection is the standard treatment for nonmetastatic GISTs. Important prognostic factors for patients with esophageal GISTs are its size and mitotic index. 

Studies have suggested that esophageal GISTs 5cm or smaller could be safely treated with esophageal enucleation.

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“With the constant development of endoscopic techniques, novel endoscopic therapeutic approaches, such as [endoscopic submucosal dissection], [endoscopic submucosal excavation], and [submucosal tunneling endoscopic resection] are popular in resecting esophageal tumors originating from the muscularis propria,” Du et al wrote.

Read more about GIST etiology 

However, long-term data on clinical outcomes of endoscopic treatment remains unclear. Hence, the research team decided to investigate whether endoscopic treatment was viable for esophageal GISTs. They obtained a total of 20 cases with histological diagnoses of esophageal GISTs between 2008 and 2020 from the Zhejiang University School of Medicine First Affiliated Hospital in Hangzhou, China.

Of the 20 cases, 11 received endoscopic treatment, and 9 underwent surgical resection. Patients that underwent endoscopic treatment had tumors between the sizes of 0.6 cm and 4 cm, while patients that underwent surgical resection had tumor sizes between 0.5 cm to 7 cm. 

The researchers discovered that tumors preferentially occurred in the mid (45%) to lower (40%) sections of the esophagus.

“There were no significant differences in gender, age, symptoms, tumor location, tumor size, mitotic index, and adjuvant imatinib therapy between the endoscopic treatment group and the surgery group,” Du and colleagues wrote. In addition, there was no statistically significant difference in disease-free survival between the 2 groups of patients studied. 

“Endoscopic treatment may be an option for the treatment of esophageal GISTs smaller than 5cm with a mitotic index no more than 5/50 [high power field],” they concluded. 


Du H, Ning L, Chen H, et al. Endoscopic treatment can be a viable therapeutic option for esophageal gastrointestinal stromal tumors. Scand J Gastroenterol. 2021;1-6. doi:10.1080/00365521.2021.2009024