The role of surgery in the management of gastrointestinal stromal tumors (GISTs) in the era of imatinib mesylate effectiveness.
Surgical resection is the treatment of choice for the gastrointestinal stromal tumors (GISTs). In the literature, the 5-year patient survival after surgical resection, ranged from 48 to 80%, before the era of imatinib mesylate and the exploration of the prognostication criteria. Imatinib mesylate targets an intracellular signaling molecule of the natural history and malignant development of GISTs, and increased the 5-year survival rate, after the resection of primary low-risk GISTs, to similar values to the normal population. For high-risk GISTs, current knowledge which is still under expansion, show major improvement at the 1-year survival rate of more than 90% versus less than 50% before imatinib era. After surgical resection, for both low and high malignant potential GISTs, a closed control directed to the early identification of confined resectable recurrences, is required. This paper assesses the current knowledge of GIST management, motivated by a case of patient with intermediate risk GIST.
Department of Surgery, General Hospital of Zakynthos Aghios Dionyssios, Peripheral National Health System PESY of Ionian Islands, Zakynthos 29100, Greece. nkosma@otenet.gr
Nikolaos
N
Kosmadakis
Evangelos-Efstathios
EE
Visvardis
Panagiotis
P
Kartsaklis
Maria
M
Tsimara
Alexandros
A
Chatziantoniou
Ioannis
I
Panopoulos
Palli
P
Erato
Paul
P
Capsambelis
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D013505:Digestive System Surgical Procedures; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate