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Background: GIST of the duodenum are rare and represent only a small subgroup of all GIST. Up to now, various surgical procedures have been described for their treatment. Both radical resections by pancreaticoduodenectomy and limited local resections are performed. This retrospective analysis was conducted for the evaluation of the results of radical and limited resections for duodenal GIST.

Methods: We retrospectively reviewed the medical records of all patients which were surgically treated for duodenal GIST at our medical institution between 2002 and 2011.

Results: Nine Patients (5M/4F) with am median age of 58 years were surgically treated. The median follow-up period was 45 month (range 6-111 month). Most often the initial symptom was gastrointestinal bleeding in 5 of 9 patients (56%). Tumors were found in all 4 parts of the duodenum, with most frequent location at the descending part of the duodenum in 4 of 9 patients (44%). In one patient the resection of the GIST was done by pancreaticoduodenectomy. Eight patients were treated by wedge or segmental resections of the duodenum. One of these limited resections was done minimally invasive; seven were done in open fashion. The median diameter of the tumors was 54mm (14-110mm). Seven resections showed microscopically negative transsection margins (R0), two showed positive margins (R1). During follow up no patient developed local recurrence. The one patient in who underwent pancreaticoduodenectomy died due to progressive disease with hepatic metastasis but without evidence of local recurrence. Another patient died of cardiac disease in complete remission. Seven out of the nine patients are alive disease-free.

Conclusion: In patients with duodenal GIST, limited surgical resection with microscopically negative margins, but interestingly also with microscopically positive margins leads to very good local and systemic disease-free survival.