Is surgery mandatory in locally advanced gastrointestinal stromal tumors after imatinib? A case report and literature review.

Riccardo Ricci, Maurizio Martini, Alessandra Cassano, Maria Teresa Congedo, Vincenzo Pio Di Noia, Carmela Di Dio, Michela Quirino, Carlo Antonio Barone, Sabrina Rossi

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

Abstract

Oesophageal gastrointestinal stromal tumors (GISTs) are rare neoplasms (about 2% ofall GISTs); radical surgery is the standard treatment of all GISTs but in case of locally advanced and unresectable disease no clear treatment guide lines are available. Studies including neoadjuvant imatinib mesylate (IM) are relatively recent, includes small sample size of heterogeneous patients and do not report a standardized duration of neoadjuvant treatment. The main question still remains whether surgery after neoadjuvant IM gives a survival benefit in locally advanced disease. A 46-year-old man with locally advanced unresectable oesophageal GIST harboring KIT exon 11 mutation was treated in our institution for 12 months with neoadjuvant IM; a reduction of 83% of tumor volume was obtained in 9-month of neoadjuvant IM, but in the last 3 months no further response was seen. After neoadjuvant therapy, patient underwent radical surgery and adjuvant IM, which is still ongoing. Since no definitive data are available about survival benefit of surgery after neoadjuvant IM in locally advanced GISTs, a careful balance between morbidity and mortality derived from surgery should be considered and more studies are needed to better define the utility and the optimal duration of neoadjuvant treatment.
Lingua originaleEnglish
pagine (da-a)E4-E9
Numero di pagine6
RivistaJournal of Gastrointestinal Oncology
Volume2017
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • GIST
  • Molecular targeted therapy

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