312 Surgical Management of Gastric GIST – a Tertiary Centre’s Experience Over 16 Years

Abstract Background Gastric gastrointestinal stromal tumours (GISTs) are rare but clinically significant, and surgical management remains a cornerstone of treatment. This study reviews our experience of gastric GISTs to identify patterns that may guide future care. Method All patients undergoing surgery for gastric GIST at a single centre, 2009 to 2025, were prospectively collected. Relevant demographic, procedural and outcome data were analysed. Chi-square and independent samples t-tests were used to assess significance. Results Eighty-five patients (M:F 40:45; mean 61.9 years) were included. Surgical techniques were: 32 open (37.6%) and 26 laparoscopic wedge (30.6%), 13 subtotal (15.3%) and 8 total gastrectomy (9.4%), and 6 other (7.1%). Laparoscopy rose significantly over time (p = 0.003). R0 resection was achieved in 94.1% of cases, with no nodal involvement seen. Post-operative imatinib was used in 30.6% of cases. Guideline adherence was 83.5%, with one case of imatinib omission despite indication. Recurrence occurred in 6 patients (7.1%) and disease-related mortality in 4 (4.7%), aligning with expected patterns (high-risk GIST, 4 (18.2%) recurrence, 3 (13.6%) disease related mortality, versus no recurrence or disease mortality in the very low-risk group). Increasing tumour size and risk classification correlate significantly with more complex resections (p = 0.007) and show trends (p = 0.057 and p = 0.078 respectively) toward association with recurrence. Margin status and guideline adherence were not significantly associated with outcomes. Low disease mortality made statistical analysis unreliable, but no significance was demonstrated. Conclusions Gastric GISTs are safely managed surgically, with favourable oncological outcomes and growing adoption of minimally invasive techniques.