BACKGROUND: We investigated the role of surgical intervention for advanced GIST after imatinib. METHODS: Among 256 patients treated with imatinib for advanced GIST, the medical records of the 34 patients who underwent surgery of residual tumors after imatinib treatment were reviewed. RESULTS: Surgery was performed on 24 patients with responsive disease (RD) after imatinib, on 3 with focal progressive disease (FP), and on 7 with generalized progressive disease (GP). All gross tumors were completely resected in 19/24 (79%), 1/3 (33%), and 1/7 (14%) patients, respectively. Disease status at surgery was associated with prognosis after surgery; with a median follow-up of 25.7 months, the median progression-free survival of patients resected for RD, FP, and GP were 27.8 months (95% CI, 17.8-37.8 months), 5.1 months (95% CI, 4.7-5.6 months), and 3.3 months (95% CI, 2.7-3.9 months), respectively (P < 0.001). Median overall survival was not reached in patients resected for RD, and was 22.5 months (95% CI, 1.4-43.0 months) and 23.5 months (95% CI, 3.0-43.9) for patients resected for FP and GP, respectively (P < 0.001). CONCLUSION: Surgical resection of tumors responsive to imatinib may be beneficial in patients with advanced GIST. Debulking surgery, however, is not recommended for patients who have already developed imatinib resistance.
BACKGROUND: We investigated the role of surgical intervention for advanced GIST after imatinib. METHODS: Among 256 patients treated with imatinib for advanced GIST, the medical records of the 34 patients who underwent surgery of residual tumors after imatinib treatment were reviewed. RESULTS: Surgery was performed on 24 patients with responsive disease (RD) after imatinib, on 3 with focal progressive disease (FP), and on 7 with generalized progressive disease (GP). All gross tumors were completely resected in 19/24 (79%), 1/3 (33%), and 1/7 (14%) patients, respectively. Disease status at surgery was associated with prognosis after surgery; with a median follow-up of 25.7 months, the median progression-free survival of patients resected for RD, FP, and GP were 27.8 months (95% CI, 17.8-37.8 months), 5.1 months (95% CI, 4.7-5.6 months), and 3.3 months (95% CI, 2.7-3.9 months), respectively (P < 0.001). Median overall survival was not reached in patients resected for RD, and was 22.5 months (95% CI, 1.4-43.0 months) and 23.5 months (95% CI, 3.0-43.9) for patients resected for FP and GP, respectively (P < 0.001). CONCLUSION: Surgical resection of tumors responsive to imatinib may be beneficial in patients with advanced GIST. Debulking surgery, however, is not recommended for patients who have already developed imatinib resistance.
Authors: George D Demetri; Margaret von Mehren; Cristina R Antonescu; Ronald P DeMatteo; Kristen N Ganjoo; Robert G Maki; Peter W T Pisters; Chandrajit P Raut; Richard F Riedel; Scott Schuetze; Hema M Sundar; Jonathan C Trent; Jeffrey D Wayne Journal: J Natl Compr Canc Netw Date: 2010-04 Impact factor: 11.908
Authors: Gil Ho Kang; Myoung Won Son; Sun Wook Han; Sang Ho Bae; Sung Yong Kim; Yong Jin Kim; Gui Ae Chung; Gyu Seok Cho; Moon Soo Lee; Nae Kyeong Park Journal: J Korean Surg Soc Date: 2012-01-27
Authors: Sebastian G de la Fuente; Jeremiah L Deneve; Colin M Parsons; Jonathan S Zager; Anthony P Conley; Ricardo J Gonzalez Journal: HPB (Oxford) Date: 2012-12-27 Impact factor: 3.647
Authors: Ferdinand Ploner; Johannes Zacherl; Friedrich Wrba; Friedrich Längle; Evelyne Bareck; Wolfgang Eisterer; Thomas Kühr; Wolfgang Schima; Michael Häfner; Thomas Brodowicz Journal: Wien Med Wochenschr Date: 2009