Management of recurrent gastrointestinal stromal tumors.

Recurrence after resection of primary gastrointestinal stromal tumor (GIST) is an unfortunately all-too-common phenomenon. The principal treatment for recurrent GIST is the first-line tyrosine kinase inhibitor (TKI) imatinib mesylate. Those who progress on, or are intolerant of imatinib, are treated with second-line TKI sunitinib malate. Cytoreductive surgery may be considered as an "adjuvant" therapy for patients with disease stabilized on imatinib, and, on an individual basis, sunitinib.