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Preoperative imatinib mesylate for unresectable or locally advanced primary gastrointestinal stromal tumors
European Journal of Surgical Oncology, 06/03/09

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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