Tomáš Šálek
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Most gastrointestinal soft tissue neoplasms, previously classified as leiomyomas, schwannomas, leiomyoblastomas or leiomyosarcomas, are today classified as GIST on the basis of molecular and immunohistological features. They originate from gastrointestinal pacemaker cells and are characterized by over-expression of the tyrosine kinase receptor KIT. Overall 5-year survival after surgical resection of GIST is approximately 60 %. However, these tumors have a wide clinical spectrum from benign to highly malignant ones. Prognostic factors have recently been identified for GIST and include tumor size, mitotic rate and other minor factors. At present, surgery is the standard treatment for primary resectable GIST. Recurrent or malignant GIST, which are resistant to radiotherapy and chemotherapy, had an extremely poor prognosis even after surgical resection, with median survival of 12 months. The development of tyrosine kinase inhibitors has changed the management of unresectable malignant cases. This new tyrosine kinase inhibitors, imatinib mesylate and sunitinib malate, have proved highly effective against GIST and have improved survival in metastatic GIST. The management of GIST-s requires a coordinated, multidisciplinary approach involving medical oncologists, diagnostic radiologists, gastroenterologists, surgeons and pathologists.