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Improvement of diagnosis and treatment of gastrointestinal stromal tumors


Author: Cernat Mircea
Degree:doctor of medicine
Speciality: 14.00.14 - Oncology and Radiotherapy
Year:2017
Scientific advisers: Nicolae Ghidirim
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Igor Mişin
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Public Medical Sanitary Intitution Institute of Oncology

Status

The thesis was presented on the 28 December, 2016
Approved by NCAA on the 16 February, 2017

Abstract

Adobe PDF document – 1.38 Mb / in romanian

Thesis

CZU [616.33/.34-006.6-089]:[616-006.03/.04]

Adobe PDF document 8.31 Mb / in romanian
178 pages

Keywords

gastrointestinal stromal tumor, computer tomography parameter, surgical treatment, immunohistochemistry, targeted therapy, risk of recurrence/metastasis, survival

Summary

The research domain: Oncology and radiotherapy.

Study aim: enhancing efficiency and improving diagnosis of gastrointestinal stromal tumor treatment results based on the multilateral analysis of clinical features, instrumental methods of diagnosis and various treatment options for these malignancies.

Objectives of the study: to study the clinical characteristics and to assess sensitivity of the instrumental methods of diagnostic in GISTs with different locations; to determine the optimum volume of surgery in patients with primary and locally advanced GISTs based on the location of the neoplasia; to specify the histopathological and immunohistochemical profile of GISTs at various sites; to identify the factors that influence tumor recurrence and metastasis; to study immediate and distant results of surgical and complex treatment of GISTs, as well as their influence on patient’s survival.

The novelty and the scientific originality: there were studied the evolution, morphological and immunohistochemical features and treatment options of GISTs. The most important factors influencing the volume of surgery were established. The immunohistochemical profile of GISTs was determined. The factors that negatively influence the risk of progression of GISTs after radical surgery were established.

The scientific problem solved: resides in determining the sensitivity of instrumental diagnostic methods of GISTs, establishing the optimum volume of surgery, specifying of histopathological features and immunohistochemical profile of GISTs, which contributed to improving the diagnosis and treatment of these neoplasms, and increased survival of patients with GISTs.

The theoretical significance: there were systematized criteria for diagnostic imaging and application of various treatment options. Peculiarities of immunohistochemical profile of GISTs were highlighted. There were developed the criteria of the risk of progression of GISTs after radical surgery.

The applicative value of the work: Recommendations were developed for the diagnostic and therapeutic options and for surgical and complex management of primary localized, locally advanced or metastatic/recurrent stomach and small intestine GISTs depending on the location of the primary tumor, the degree of malignancy and primary tumor size.

The implementation of the scientific results:The study results were applied in everyday practice of the scientific Laboratory of gastric and thoracic surgery, Laboratory of tumor morphology and Consultativediagnostic Centre of the PMSI IOM.