A specialized medical team at King’s College Hospital London – Jeddah successfully saved the life of a patient suffering from a giant gastric gastrointestinal stromal tumor (GIST), in one of the most complex gastrointestinal oncology surgeries, led by Prof. Dr. Mohamed Hafez, Consultant Surgical Oncology.
The patient arrived at the hospital experiencing severe chronic pain and internal gastric bleeding, resulting from a recurrence of the tumor after a previous surgery performed nearly 15 years ago. This time, however, the tumor had returned with an exceptional size of approximately 20 cm, extending to the diaphragm and pancreas, and located in extremely close proximity to the gastroesophageal junction. This posed a direct threat to the patient’s life and represented a highly delicate surgical challenge.
Comprehensive medical investigations revealed that the tumor was completely resistant to medical therapy. The patient showed no response to Imatinib (Gleevec) even after dose escalation, and was unable to tolerate alternative treatments due to their side effects, leaving complete surgical resection as the only viable therapeutic option.
Meticulous Preoperative Planning
Given the complexity of the case and the high surgical risk—due to the patient’s advanced age, cardiac medical history, anemia, and previous surgery with severe adhesions—the case was thoroughly reviewed by the hospital’s Multi-Disciplinary Team (MDT).
The planning and execution involved a fully integrated medical team, including oncology, gastrointestinal surgery, thoracic surgery, interventional radiology, anesthesia, pain management, intensive care, laboratory and pathology, and clinical nutrition, with additional specialties on standby.
Due to the tumor’s adhesion to the spleen and the confirmed need for splenectomy, a proactive step was taken by embolizing the splenic arteries via interventional radiology to reduce the risk of intraoperative bleeding, particularly in light of the patient’s anemia.
Precise Surgery with Outstanding Results
The operation was performed exactly as planned and lasted approximately 2 hours and 40 minutes, despite initial expectations that it might exceed five hours due to the severity of adhesions, the tumor’s critical location, and its proximity to vital organs.
The tumor was removed en bloc, with complete preservation of the extremely fragile tumor capsule, as any rupture could have altered the disease stage and significantly increased the risk of recurrence.
During the procedure, the laboratory team played a pivotal role by providing rapid intraoperative frozen section analysis to confirm clear surgical margins, with reassuring results delivered promptly.
Smooth Recovery Without Complications
The patient was transferred to the intensive care unit for one day as a precautionary measure, then moved to the inpatient ward. His postoperative care involved a multidisciplinary team, including clinical nutrition—given the partial gastrectomy—physiotherapy, and cardiology due to his cardiac history.
The patient was discharged after only six days, able to eat and drink normally, with no recorded surgical or medical complications.
A Medical Achievement
Prof. Dr. Mohamed Hafez, Consultant Surgical Oncology at King’s College Hospital London - Jeddah, stated that this case represents one of the most complex gastrointestinal tumor cases, noting that the tumor’s size, extension to vital organs, complete resistance to medical therapy, and the presence of prior surgery significantly elevated the surgical risk.
He added: “Success in this operation was not based on individual surgical skill alone, but on a fully integrated system that began with accurate diagnosis, continued through meticulous multidisciplinary planning, and extended to precise surgical execution and postoperative follow-up. This approach was reflected in the patient’s smooth recovery and discharge within six days without complications.”
The medical team confirmed that this achievement reflects King’s College Hospital London – Jeddah’s capability to manage the most complex oncological surgeries in the Kingdom of Saudi Arabia, supported by multidisciplinary integration, advanced planning, and state-of-the-art medical resources.
They further noted that such procedures reaffirm that traveling abroad for treatment has become a personal choice rather than a medical necessity, given the availability of highly skilled medical expertise and advanced capabilities within Saudi hospitals.