title: Clinical presentation and treatment of gastrointestinal stromal tumors.
abstract: OBJECTIVE
  Gastrointestinal stromal tumors (GISTs), although rare, are the most common mesenchymal neoplasms affecting the gastrointestinal tract. We present our experience in the treatment of localized and metastatic disease and a review of literature.
  
  
  METHODS
  Nine patients were observed from April 2002 to July 2004. Eight tumors were in the gastric area and 1 was in the small bowel. In 5 cases, complete surgical removal was performed, and none of these patients underwent adjuvant therapy. The remaining 4 cases, with locally advanced or recurrent disease, were treated with imatinib.
  
  
  RESULTS
  The patients with localized disease treated only by surgery did not relapse. In the patients with locally advanced or metastatic disease treated by imatinib, we observed 3 partial responses, and one case was not assessable because he had no measurable disease. In 2 of 3 responders, it was possible to perform a new radical surgery.
  
  
  CONCLUSIONS
  Our series is too small to draw any conclusion. According to our review of the literature, surgery remains the standard treatment for non-metastatic GISTs. Imatinib mesylate represents a major breakthrough in the treatment of advanced GISTs and is the first effective systemic therapy for the disease.
authors.affiliation: University of Palermo, Department of Oncology, Division of General and Oncological Surgery, Italy. calogero.cipolla@tin.it
authors.forename: Calogero
authors.initials: C
authors.lastname: Cipolla
authors.forename: Fabio
authors.initials: F
authors.lastname: Fulfaro
authors.forename: Luigi
authors.initials: L
authors.lastname: Sandonato
authors.forename: Salvatore
authors.initials: S
authors.lastname: Fricano
authors.forename: Gianni
authors.initials: G
authors.lastname: Pantuso
authors.forename: Nello
authors.initials: N
authors.lastname: Grassi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Vieni
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Valerio
authors.forename: Rea
authors.initials: R
authors.lastname: Lo Dico
authors.forename: Nicola
authors.initials: N
authors.lastname: Gebbia
authors.forename: Mario Adelfio
authors.initials: MA
authors.lastname: Latteri
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use*; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate