Principles of follow-up for gastrointestinal mesenchymal tumors

  The risk of recurrence after GIST surgery is real, and the most common sites of metastasis are the peritoneum and liver. Assessment of the risk of recurrence helps to establish a schedule for routine follow-up. High-risk patients may recur within 2-3 years after surgery, while low-risk patients may recur much later.  Enhanced CT scan of the abdomen is recommended as a routine follow-up.  a. For intermediate and high-risk patients, abdominal CT scans should be performed every 3-4 months for 3 years, then every 6 months until 5 years b. For low-risk patients, abdominal CT scans should be performed every 6 months for 5 years For patients with metastatic recurrence under treatment, tumor response and disease progression should be closely monitored. A reasonable follow-up schedule is recommended as follows: 1. Baseline enhanced CT data must be available before treatment as a basis for efficacy assessment 2. Enhanced CT scan or MRI follow-up should be done at least every three months after starting treatment 3. Close monitoring in the first three months of treatment is very important. PET-CT should be done when necessary to confirm the tumor response to treatment.