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38

NCCN Guidelines for Patients

®

Soft Tissue Sarcoma, Version 1.2014

This chapter is about GISTs. These

tumors may start in cells that trigger

muscle movement in the gut wall.

Part 4 starts by listing what is needed

for treatment planning. Next, treatment

options are presented for <2 cm

stomach GISTS, all other GISTS, and if

GISTS keep growing while taking drug

treatment.

Treatment planning

4

Gastrointestinal

stromal tumors

38 Treatment planning

42 Treatment for small stomach GISTs

44 Treatment for other GISTs

46 Treatment after progression

48 Review

Must haves

Multidisciplinary team

Medical history and physical exam

Biopsy if

• <2 cm stomach tumor,

• ≥2 cm GI tumor and may have other types

of treatment before surgery, or

• ≥2 cm GI tumor and can’t have surgery but

will have other treatment

Imaging of abdomen and pelvis

• CT (

c

omputed

t

omography) for <2 cm

stomach tumors

• CT or MRI (

m

agnetic

r

esonance

i

maging)

for ≥2 cm tumor

KIT and PDGFRA testing for ≥2 cm tumor

Sometimes useful

Imaging of chest

Endoscopy ± ultrasound

PET (

p

ositron

e

mission

t

omography)

SDH (

s

uccinate

d

e

h

ydrogenase) gene testing