Clinical presentation and treatment of gastrointestinal stromal tumors.
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.
Cipolla
Calogero
C
University of Palermo, Department of Oncology, Division of General and Oncological Surgery, Italy. calogero.cipolla@tin.it
Fulfaro
Fabio
F
Sandonato
Luigi
L
Fricano
Salvatore
S
Pantuso
Gianni
G
Grassi
Nello
N
Vieni
Salvatore
S
Valerio
Maria Rosaria
MR
Lo Dico
Rea
R
Gebbia
Nicola
N
Latteri
Mario Adelfio
MA
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
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D000068877:Imatinib Mesylate