Furthermore, the study is also underpowered to provide information
about differences in survival in those patients who were referred to the regional centre (post 2006) compared to those treated locally. Conclusions Currently there is still a lack of clear guidelines for referral and follow up of patients diagnosed incidentally with GICTs particularly within the setting of district general hospitals within the UK. With the recent published evidence about the staging, Sorafenib Tosylate buy treatment options and prognosis of carcinoid tumours, this Inhibitors,research,lifescience,medical should be feasible and efforts should be made to align the delivery of care to these patients in tandem with the tertiary centres. The hope remains that better and / or modern treatment pathways for carcinoid tumours delivered in a regional setting would be reflected in a difference in survival. Hence, there is a need for more Inhibitors,research,lifescience,medical NET-MDTs nationwide in order to provide a co-ordinated approach in the management of this rare condition. Acknowledgements The authors will like to thank the help of Dr K. Jain, Consultant pathologist, South Tyneside General Hospital, South Shields for her help in searching the histopathology database for obtaining the list of patients eligible Inhibitors,research,lifescience,medical for inclusion in the study and also providing the photomicrographs of immune-histochemical staining. Footnotes No potential
conflict of interest.
Over the last decade, gastrointestinal stromal tumor (GIST) became the most commonly diagnosed mesenchymal tumor of the gastrointestinal tract (1,2). Population-based studies suggest an annual
incidence of between 11 and 14.5 per million and a prevalence of 129 per million (3). The immunohistochemistry of GIST shows the presence Inhibitors,research,lifescience,medical of cell-surface antigen CD117 (KIT), which represents a defining characteristic of GIST (4-7). Immunostaining is essential Inhibitors,research,lifescience,medical to differentiate GISTs from other more rare mesenchymal tumors. Differential diagnosis includes leiomyosarcomas, leiomyomas and schwannomas (3). It is believed that GISTs arise from a neoplastic transformation of the intestinal pacemaker cells known as the interstitial cells of Cajal (ICC) (6,8). Prior to 2002, the only available therapeutic option for patients with localized GISTs was surgical resection (9). Unfortunately, even when excised in negative surgical margins, the recurrence rate for lesions larger than 3 cm was found GSK-3 to be significant. Introduction of the first tyrosine kinase inhibitor, imatinib mesylate, has dramatically changed the management options available for GIST patients (10). The role of radiation therapy in the treatment of GISTs has not been documented (11). In the past, clinicians were reluctant to use radiation therapy due to concerns over the dose received by normal tissues, mostly the potential gastrointestinal toxicity. As such, radiation therapy has been utilized rarely, mostly for palliation purposes (12).