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However, they included only a small number of gastric GISTs, and their long-term follow-up results have not yet been reported. Recent studies have reported no recurrence of gastric GISTs resected by endoscopic procedure; however, their follow-up periods were relatively short, ranging from 1 to 2 years [16,17]. Here, we show our clinical outcomes Torin 1 purchase of endoscopic resection for gastric GISTs [18]. A total of 249 patients with SET in the UGIT underwent endoscopic resection in our hospital; among them, 89 cases were confirmed as gastric GIST by histopathologic examination. The most common site of the gastric GISTs was the gastric body (43.3%), followed by the cardia (22.2%) and fundus (21.1%). The mean tumor size was 2.3��1.2 cm, and most were considered to have originated from the MP layer (64.4%) based on pre-procedural EUS findings. Most of the tumors were resected by endoscopic submucosal dissection (80.0%), followed by submucosal tunneling endoscopic resection (8.9%), and two cases (2.2%) by endoscopic full-thickness resection. The complication rate was 14.4%, including micro- and macroperforation (5.6%/4.4%, respectively) and major bleeding (2.2%). The recurrence rate was relatively low (2.2%) during the long-term follow-up period (46.0��28.5 months) despite the low R0 resection rate (25.0%) and did not differ significantly from that of surgically resected gastric GIST (5.0%). This comparable recurrence rate may be explained by the fact that most of the gastric GISTs in the endoscopic resection group had smaller sizes and low mitotic index counts (Hesperadin which consequently corresponded to very low (50.0%) and low (31.1%) risk. Indeed, if a GIST is completely resected without residual tumor in an endoscopic view and is classified as lower risk by histopathological evaluation, the endoscopic procedure may be an ABT-737 order alternative choice for optimal treatment of GIST in the UGIT, even with R1 resection margins. Further evaluation with large-scale prospective studies is needed to clarify this issue. CONCLUSIONS Endoscopic resection of gastric GIST is increasingly used for tissue diagnosis and treatment, and is expected to be a substitute for surgical resection in selected cases. Endoscopic resection is a feasible and effective alternative therapeutic modality for lower risk gastric GIST with acceptable long-term follow-up results. Footnotes Conflicts of Interest: The author has no financial conflicts of interest.""A sufficient resection margin is recommended for complete resection of malignant tumors and reduction of the risk of residual tumor or recurrence. Especially in patients with adenocarcinoma in the gastrointestinal (GI) tract, survival can be affected by tumor recurrence from a microscopic residual tumor in the resection margin. Therefore, surgical resection of adenocarcinomas in the GI tract is recommended to close the abdomen after confirmation of the tumor-negative pathologic margin in frozen sections.