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Resection of residual disease in patients with metastatic gastrointestinal stromal tumors responding to treatment with imatinib
Author(s) -
Bauer Sebastian,
Hartmann Jörg Thomas,
de Wit Maike,
Lang Hauke,
Grabellus Florian,
Antoch Gerald,
Niebel Wolfgang,
Erhard Jochen,
Ebeling Peter,
Zeth Matthias,
Taeger Georg,
Seeber Siegfried,
Flasshove Michael,
Schütte Jochen
Publication year - 2005
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.21164
Subject(s) - gist , imatinib , medicine , oncology , tyrosine kinase inhibitor , disease , imatinib mesylate , stromal tumor , sunitinib , surgery , stromal cell , pathology , cancer , myeloid leukemia
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. Long‐term survival of patients with metastatic disease has only been observed in patients with completely resected disease. Recently, the tyrosine kinase inhibitor imatinib has been found to yield responses in the majority of patients with metastatic GIST suggesting improved resectability in responding patients. Combined treatment approaches including resective surgery after imatinib treatment in patients with advanced metastatic disease have rarely been explored. We report a series of 90 patients with metastatic GIST in whom treatment with imatinib enabled 12 patients with mostly recurrent and extensive disease to be considered for resection of residual disease. In 11 of these patients, complete resection could be achieved. Viable tumor cells were found in all but one resected specimens suggesting that despite favorable radiological or clinical responses, imatinib is unlikely to induce pathological complete responses. Until more mature data from prospective trials are available, these data suggest that an early aggressive surgical approach should be considered for all patients with metastatic GIST. Further trials investigating a combined surgical and pre/postoperative treatment with imatinib in patients with advanced metastatic GIST are warranted. © 2005 Wiley‐Liss, Inc.