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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2007

01-01-2007

Surgical Resection of Gastrointestinal Stromal Tumors After Treatment with Imatinib

Authors: Robert H. I. Andtbacka, MD, CM, Chaan S. Ng, MD, Courtney L. Scaife, MD, Janice N. Cormier, MD, MPH, Kelly K. Hunt, MD, Peter W. T. Pisters, MD, Raphael E. Pollock, MD, PhD, Robert S. Benjamin, MD, Michael A. Burgess, MD, Lei L. Chen, MD, PhD, Jonathan Trent, MD, Shreyaskumar R. Patel, MD, Kevin Raymond, MD, Barry W. Feig, MD

Published in: Annals of Surgical Oncology | Issue 1/2007

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Abstract

Background

Surgical resection of gastrointestinal stromal tumors (GISTs) has been the most effective therapy for these rare tumors. Imatinib has been introduced as systemic therapy for locally advanced and metastatic GIST. In this study, the surgical resection rates and long-term outcomes of patients treated with preoperative imatinib for locally advanced primary, recurrent, or metastatic GISTs were evaluated.

Methods

Patients were retrospectively assessed for completeness of surgical resection and for disease-free and overall survival after resection.

Results

Forty-six patients underwent surgery after treatment with imatinib. Eleven were treated for locally advanced primary GISTs for a median of 11.9 months, followed by complete surgical resection. All eleven were alive at a median of 19.5 months, and ten were free of disease. Thirty-five patients were treated for recurrent or metastatic GIST. Of these, eleven underwent complete resection. Six of the eleven patients had recurrent disease at a median of 15.1 months. All eleven patients were alive at a median of 30.7 months. Patients with a partial radiographic tumor response to imatinib had significantly higher complete resection rates than patients with progressive disease (91% vs. 4%; P < .001). Of the 24 patients with incomplete resection, 18 initially responded to imatinib but were unable to undergo complete resection after they progressed before surgery.

Conclusions

Preoperative imatinib can decrease tumor volume and is associated with complete surgical resection in locally advanced primary GISTs. Early surgical intervention should be considered for imatinib-responsive recurrent or metastatic GIST, since complete resection is rarely achieved once tumor progression occurs.
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Metadata
Title
Surgical Resection of Gastrointestinal Stromal Tumors After Treatment with Imatinib
Authors
Robert H. I. Andtbacka, MD, CM
Chaan S. Ng, MD
Courtney L. Scaife, MD
Janice N. Cormier, MD, MPH
Kelly K. Hunt, MD
Peter W. T. Pisters, MD
Raphael E. Pollock, MD, PhD
Robert S. Benjamin, MD
Michael A. Burgess, MD
Lei L. Chen, MD, PhD
Jonathan Trent, MD
Shreyaskumar R. Patel, MD
Kevin Raymond, MD
Barry W. Feig, MD
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9034-8

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