Gastrointestinal mesenchymal tumor, a somewhat awkward name, is not only unfamiliar to people, but also to many health care professionals. Where does gastrointestinal mesenchymal tumor grow? Is it the same as stomach or intestinal cancer? How can it be detected and treated early? Easy to confuse: it is similar to many digestive tract diseases. According to Professor He Yulong, Director of the Gastrointestinal Mesenchymal Tumor Clinic of the First Affiliated Hospital of Sun Yat-sen University and the Gastrointestinal Cancer Clinic of Sun Yat-sen University, gastrointestinal mesenchymal tumor is a new medical term that was officially named and commonly used only at the beginning of this century. Due to the hidden symptoms and non-specific clinical symptoms in the early stage of the disease, pathological examination could not distinguish and identify gastrointestinal mesenchymal tumor before this century, and it has long been mistaken for smooth muscle tumor and smooth muscle sarcoma, and often confused with gastrointestinal nerve sheath tumor and gastrointestinal autonomic nerve tumor. As a soft tissue tumor of the gastrointestinal tract, gastrointestinal mesenchymal tumor is different from gastric or intestinal cancer, it can occur in any part of the gastrointestinal tract, among which the stomach is the most common primary, accounting for 50%-70%; followed by the small intestine, accounting for 20%-30%; colorectum, accounting for 10%-20%; and esophagus, accounting for about 6%. 50-70 years old is the high incidence of the disease. Easy to ignore: insidious symptoms cause delay in treatment. In the past, gastrointestinal mesenchymal tumor was considered a rare disease because of the low diagnosis rate. In recent years, with the continuous improvement of treatment and clinical research, its detection rate has been increasing. According to the statistics of western countries, gastrointestinal mesenchymal tumor accounts for about 1/5 of all sarcomas and has become the most common type of single sarcoma. Dr. Xinhua Zhang of the Gastrointestinal Mesenchymal Tumor Diagnostic and Treatment Center of the First Affiliated Hospital of Sun Yat-sen University said, “Although more and more patients are threatened by gastrointestinal mesenchymal tumor, unfortunately, the public knows little about this disease, and coupled with the insidious nature of gastrointestinal mesenchymal tumor in its early stages, it fails to attract attention.” According to the report, gastrointestinal mesenchymal tumor is basically asymptomatic when it is small in early stage, even though with the increase of tumor, patients will show some obvious symptoms, including nausea, vomiting, abdominal pain, black stool and anemia, but these symptoms are also seen in other gastrointestinal diseases, so it is easy to be ignored and missed. Among patients with gastrointestinal mesenchymal tumors who first present, 20-30% have developed into advanced stages; 11-47% have developed liver metastases and abdominal metastases, missing the best time for treatment. Prone to recurrence: insensitive to radiotherapy chemotherapy. ”It is currently believed that gastrointestinal mesenchymal tumors are essentially malignant, and seemingly benign mesenchymal tumors eventually become malignant.” The degree of malignancy of gastrointestinal mesenchymal tumors is roughly divided into: ultra-low risk (tumor <2cm), low risk (tumor 2cm-5cm), intermediate risk (tumor 5cm-10cm), and high risk (tumor >10cm). Ultra-low-risk, low-risk and intermediate-risk patients have a better prognosis and are less prone to recurrence and metastasis after undergoing surgical resection, while high-risk patients are prone to recurrence and metastasis. So, how can early detection be achieved? Since gastrointestinal mesenchymal tumors have no characteristic symptoms and are highly prevalent in people over 50 years old, a gastroscopy for people over 45 years old can help detect early tumors. Generally speaking, most gastrointestinal mesenchymal tumors can be ruled out through endoscopy. “Currently, surgical resection is the preferred and only possible cure for gastrointestinal mesenchymal tumors. In mesenchymal tumors, a strong emphasis is placed on complete resection, and any inappropriate first surgery (e.g., rupture of the tumor intraoperatively) may lead to postoperative recurrence. Therefore, laparoscopic surgery should be chosen with caution.” For high-risk patients, the recurrence rate after surgery can be 55-90 percent, and half also have concomitant liver metastases, which are related to their active cell growth, especially for mesenchymal tumors located in the small intestine, which are cut and grown like leeks, and some patients have had multiple surgeries as a result. Since gastrointestinal mesenchymal tumors are insensitive to radiotherapy and chemotherapy, there was no better treatment option other than surgery in the past. With the introduction of molecular targeted drugs, the treatment of mesenchymal tumors has gained a breakthrough. Pre-operative targeted drugs can be taken orally to shrink the lesions and create conditions more conducive to surgical eradication; in the adjuvant treatment after surgical resection, taking targeted drugs can delay recurrence and improve the survival rate of patients.