eMedicine Specialties > Gastroenterology > Intestine

Intestinal Leiomyosarcoma: Follow-up

Author: Richard K Spence, MD, Senior Vice President for Clinical Affairs, Infonale
Coauthor(s): George Brasinikas, MD, Staff Physician, Department of Pathology, Birmingham Baptist Medical Center
Contributor Information and Disclosures

Updated: Nov 9, 2006

Follow-up

Further Outpatient Care

  • Local and systemic recurrence is a real possibility, and even a probability, in many cases. Closely monitor the patient for such a recurrence, but specific guidelines for follow-up are lacking because of the relatively rare nature of this tumor.
  • Certainly, regularly scheduled CT scans and, as appropriate, endoscopic examinations together with blood work (blood counts and liver profile) should be performed. The authors suggest a follow-up CT scan of the abdomen and endoscopy, if possible, at 3 and 6 months after surgery. This is followed with yearly screening.
  • Stool should be screened for occult blood with the same frequency.
  • Any abdominal complaint should be evaluated aggressively.
  • A chest radiograph should be performed with each screening, together with a blood count.

Prognosis

  • With curative resection, the 5-year survival rate for patients with leiomyosarcoma of the small intestine is 40-50%, according to Hill's review in 1998.
  • In cases in which the grade of the tumor was documented, the median survival for patients with high-grade tumors was 25 months in one study, whereas the median survival for patients with low-grade tumors was approximately 98 months (Evans HL, 1985).
  • A benign initial report on a resected tumor does not remove the patient from consequences because these tumors sometimes recur as malignancies—about 6% in one study (Ludwig, 1996).

Miscellaneous

Medicolegal Pitfalls

  • Positive test results for occult blood in the stool of a patient demand a source. If colonoscopy and EGD results are negative, investigate the small bowel with a radio-opaque follow-through or further endoscopy.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Jill Halonen, MD, to the development and writing of this article.



More on Intestinal Leiomyosarcoma

Overview: Intestinal Leiomyosarcoma
Differential Diagnoses & Workup: Intestinal Leiomyosarcoma
Treatment & Medication: Intestinal Leiomyosarcoma
Follow-up: Intestinal Leiomyosarcoma
Multimedia: Intestinal Leiomyosarcoma
References
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References

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  8. Zhan J, Xia ZS, Zhong YQ, et al. Clinical analysis of primary small intestinal disease: A report of 309 cases. World J Gastroenterol. Sep 1 2004;10(17):2585-7. [Medline].

  9. Zhan WH, Wang PZ, Shao YF, et al. Efficacy and safety of adjuvant post-surgical therapy with imatinib in gastrointestinal stromal tumor patients with high risk of recurrence: interim analysis from a multicenter prospective clinical trial [in Chinese]. Zhonghua Wei Chang Wai Ke Za Zhi. Sep 2006;9(5):383-7.

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Further Reading

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Keywords

gut stromal tumors, gastrointestinal stromal tumors, GISTs

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Contributor Information and Disclosures

Author

Richard K Spence, MD, Senior Vice President for Clinical Affairs, Infonale
Richard K Spence, MD is a member of the following medical societies: American Association of Blood Banks, American College of Physician Executives, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Medical Writers Association, American Society for Artificial Internal Organs, American Society for Parenteral and Enteral Nutrition, American Venous Forum, Association for Academic Surgery, Association for Surgical Education, Biomedical Engineering Society, Eastern Vascular Society, International College of Angiology, Medical Society of New Jersey, Medical Society of the State of New York, New York Academy of Sciences, Pan-Pacific Surgical Association, Peripheral Vascular Surgery Society, Shock Society, Society for Clinical Vascular Surgery, Society for Experimental Biology and Medicine, Society for Surgery of the Alimentary Tract, Society for Vascular Surgery, Society of Critical Care Medicine, Society of University Surgeons, Southeastern Surgical Congress, Surgical Infection Society, Transplantation Society, and Wound Healing Society
Disclosure: Nothing to disclose.

Coauthor(s)

George Brasinikas, MD, Staff Physician, Department of Pathology, Birmingham Baptist Medical Center
George Brasinikas, MD is a member of the following medical societies: American Medical Association, College of American Pathologists, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

Medical Editor

Rajeev Vasudeva, MD, FACG, Clinical Professor of Medicine, Consultants in Gastroenterology, University of South Carolina School of Medicine
Rajeev Vasudeva, MD, FACG is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy, and South Carolina Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Noel Williams, MD, Professor Emeritus, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Professor, Department of Internal Medicine, Division of Gastroenterology, University of Alberta, Edmonton, Alberta, Canada
Noel Williams, MD is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Assistant Dean for Medical Curriculum, Associate Professor of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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