Locally advanced gastrointestinal stromal tumors: Surgical strategies and outcomes in a referral hospital in Sub-Saharan Africa
Abstract
Introduction Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract but remain rare overall. Locally advanced forms present therapeutic challenges, particularly in low-resource settings. Methods We conducted a descriptive cross-sectional study with retrospective data collection at the Hubert Koutoukou Maga National University Hospital Center (CNHU-HKM) in Benin. All patients with locally advanced GIST managed between January 2010 and January 2025 were included. Clinical features, management strategies and surgical outcomes were analyzed. Results Nine patients with locally advanced GIST were identified (male-to-female ratio 3.5:1). The stomach was the most frequent primary site (n = 5). Adjacent organ invasion involved the pancreas (n = 5), the spleen (n = 5), and the colon (n = 2). Seven patients received neoadjuvant imatinib. Seven patients underwent open surgical resection, which included en bloc removal of the primary tumor along with the involved adjacent organs or structures, in order to achieve complete (R0) resection whenever technically feasible. At last follow-up, five patients were alive (including one awaiting reoperation for local recurrence), three were lost to follow-up, and one had died. Conclusion This small series demonstrates the feasibility of integrating neoadjuvant therapy with surgery for locally advanced GIST in a low-resource African setting. The high rate of R0 resections achieved underscores the value of multimodal management, even in contexts where diagnosis is often delayed and therapeutic resources are limited.
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BibTeX
@article{gnangnon2026locally,
title = {{Locally advanced gastrointestinal stromal tumors: Surgical strategies and outcomes in a referral hospital in Sub-Saharan Africa}},
author = {Freddy Houéhanou Rodrigue Gnangnon and Ismaïl Lawani and Sonia Fernande Djedeme and Adémola Lionel Destiny Padonou and Roland Goudou and Dansou Gaspard Gbessi and Aboudou Raïmi Kpossou and Jean Sehonou},
journal = {Clinical Surgical Oncology},
year = {2026},
month = nov,
doi = {10.1016/j.cson.2026.100118},
url = {https://hal.science/hal-05849874v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Locally advanced gastrointestinal stromal tumors: Surgical strategies and outcomes in a referral hospital in Sub-Saharan Africa
AU - Freddy Houéhanou Rodrigue Gnangnon
AU - Ismaïl Lawani
AU - Sonia Fernande Djedeme
AU - Adémola Lionel Destiny Padonou
AU - Roland Goudou
AU - Dansou Gaspard Gbessi
AU - Aboudou Raïmi Kpossou
AU - Jean Sehonou
PY - 2026
DA - 2026/11/03
JO - Clinical Surgical Oncology
DO - 10.1016/j.cson.2026.100118
UR - https://hal.science/hal-05849874v1
AB - Introduction Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract but remain rare overall. Locally advanced forms present therapeutic challenges, particularly in low-resource settings. Methods We conducted a descriptive cross-sectional study with retrospective data collection at the Hubert Koutoukou Maga National University Hospital Center (CNHU-HKM) in Benin. All patients with locally advanced GIST managed between January 2010 and January 2025 were included. Clinical features, management strategies and surgical outcomes were analyzed. Results Nine patients with locally advanced GIST were identified (male-to-female ratio 3.5:1). The stomach was the most frequent primary site (n = 5). Adjacent organ invasion involved the pancreas (n = 5), the spleen (n = 5), and the colon (n = 2). Seven patients received neoadjuvant imatinib. Seven patients underwent open surgical resection, which included en bloc removal of the primary tumor along with the involved adjacent organs or structures, in order to achieve complete (R0) resection whenever technically feasible. At last follow-up, five patients were alive (including one awaiting reoperation for local recurrence), three were lost to follow-up, and one had died. Conclusion This small series demonstrates the feasibility of integrating neoadjuvant therapy with surgery for locally advanced GIST in a low-resource African setting. The high rate of R0 resections achieved underscores the value of multimodal management, even in contexts where diagnosis is often delayed and therapeutic resources are limited.
SN - 2773-160X
ER -