Surgery for Gastrointestinal Stromal Tumor

Surgery is usually main treatment for gastrointestinal stromal tumors (GISTs) that haven’t spread. The goal of the surgery is to remove all of the cancer.

The type of surgery needed depends on the location and size of the tumor.

Surgery for small GISTs

If the tumor is small, it often can be removed along with a small area of normal tissue around it. This is done through a cut (incision) in the skin. Unlike many other cancers, GISTs almost never spread to the lymph nodes, so removing nearby lymph nodes is usually not needed.

For some small cancers, “keyhole” (laparoscopic) surgery is an option. Instead of making a large incision in the skin to remove the tumor, several small ones are used. The surgeon inserts a thin lighted tube with a tiny video camera on the end (a laparoscope) through one of them. This lets him or her see inside the belly. Long, thin surgical tools are then used through the other incisions to remove the tumor. Because the incisions are small, patients usually recover more quickly from this type of surgery than from traditional surgery that requires a longer incision.

Surgery for larger GISTs

If the tumor is large or growing into other organs, the surgeon might still be able to remove it entirely. To do this, parts of organs (such as a section of the intestines) might need to be removed. The surgeon might also remove tumors that have spread elsewhere in the abdomen, such as the liver.

Another option for tumors that are large or have grown into nearby areas might be to have the patient take the targeted drug imatinib (Gleevec) first. This can often shrink the tumor, which can make it easier to remove with surgery.

Choosing your surgeon

No matter what type of surgery is done, it's very important that it is done by a surgeon experienced in treating GISTs. GISTs are often delicate tumors, and surgeons must be careful not to open the outer lining that surrounds them (known as the capsule), because it might increase the risk of spreading the cancer. GISTs also tend to have a lot of blood vessels, so your surgeon has to be careful to control any bleeding from the tumor.

For more information about surgery, see Cancer Surgery.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Casali PG, Dei Tos AP, Gronchi A. Chapter 55: Gastrointestinal Stromal Tumor. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015.

National Cancer Institute. Physician Data Query (PDQ). Gastrointestinal Stromal Tumors Treatment. 2017. Accessed at www.cancer.gov/types/soft-tissue-sarcoma/hp/gist-treatment-pdq on April 17, 2017.

National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Soft Tissue Sarcoma. V.2.2017. Accessed at  www.nccn.org/professionals/physician_gls/pdf/sarcoma.pdf on April 17, 2017.

Last Medical Review: May 17, 2017 Last Revised: May 17, 2017

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