Why Follow-Up Care Matters After GIST Cancer Surgery

Follow-up care and monitoring remain essential for patients with gastrointestinal stromal tumors (GIST) even after successful treatment, according to Dr. Weijing Sun, associate director at the University of Kansas Cancer Center.

Sun explained that after curative surgery, patients need regular surveillance to track tumor features such as size, mutations and growth patterns. Those with higher-risk factors may also need adjuvant therapy after surgery to help reduce the chance of recurrence.

Transcript

How important is follow-up care and ongoing monitoring for patients, even after successful treatment, and what should patients with this diagnosis expect long term?

It’s important. That’s a very important situation, even for those patients who had curative-intent surgery. Then the question is, you need to know the pathology of the tumor, which means when the tumor is removed, especially pathology, they are going to detail the size, the mitosis, the mutation. And it depends, of course. Everybody, regardless of situation, you need surveillance — means follow-up closely.

And then the second population is patients who need adjuvant treatment. Even if surgery removed the tumor, for those people in the intermediate- or high-risk group — which means the tumor size is bigger than expected, like five to 10 centimeters, or with mitosis more than five, or with this mutation — then adjuvant treatment means you give some treatment after surgery to decrease the chance for cancer to come back, called recurrence.

So commonly, surveillance means for the first five years, you need every three to six months to go see the doctor, and either receive endoscopy or CT scan, to evaluate and make sure there is no evidence of disease. After five years, most people will suggest continuing periodic follow-up, sometimes still with endoscopy.

There is also one small group of people who have risk of inherited disease — which can be genetically related, high risk, especially something called SDH deficiency. Sounds complicated, but you always need biological and genetic assessment. For those with family risk — for example, more than one family member with the same disease, or disease developing at a younger age — I always ask patients to get genetic consultation, especially with a geneticist expert, to understand: do you or do you not have some risk of family inherited situation? That can help for long-term follow-up as well.

So those are the factors. Even if you had curative surgery, number one, you need surveillance. Number two, some patients need treatment to decrease risk of recurrence. And number three, it’s best to also have genetic follow-up, to make sure there is no inherited risk for yourself and also for other family members.

Transcript has been edited for clarity and conciseness.

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