Preoperative imatinib mesylate for unresectable or locally advanced primary gastrointestinal stromal tumors
Fiore M et al. - In unresectable or locally advanced gastrointestinal stromal tumor (GISTs), preoperative imatinib mesylate (IM) is a useful tool both to improve resectability and reduce surgical morbidity. Methods- Aim was to investigate the effect of preoperative IM in pts with unresectable or locally advanced primary GIST
- From Jan 2003 to Jan 2008, all pts affected by bulky localized GIST were considered for preoperative IM with cytoreductive intent
- Clinical, pathological and molecular characteristics were assessed and the rate of response recorded
- Progression-free survival (PFS) was calculated according to Kaplan–Meier analysis
Results- 15 pts: 1 esophageal, 7 gastric, 3 duodenal, 4 rectal GISTs received preoperative IM for a median of 9 mo
- All pts had tumor shrinkage, with a median size reduction of 34%
- 1 patient had radiological CR
- In all cases an improvement of the originally planned surgical procedure was obtained:
- 3 pts initially considered unresectable underwent complete surgery
- 7 pts with initial indication for extensive surgery were more conservatively operated on
- 4 pts initially deemed at high perioperative risk underwent safe surgery
- PFS at 3 yrs from IM onset was 77%
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