title: [Long-term survival after surgery and adjuvant imatinib in a patient with rectal GIST, local recurrence, liver metastases and mediastinal pleural metastasis].
abstract: Imatinib is a standard treatment for metastatic GIST. Surgery is an optional treatment for local recurrence and resectable liver metastasis. We report a case of high risk group rectal GIST with local recurrence, liver metastases and mediastinal pleural metastasis. Long-term survival (7 years and 10 months) was achieved with imatinib after resection. A 63-year-old man underwent a surgery for undifferentiated esophageal cancer and simultaneously was diagnosed a rectal submucosal tumor of 3 cm by digital examination in 2001. After 2 years, he underwent Miles' operation because of an increase of the rectal submucosal tumor. The histological examination revealed a high risk group GIST. PET-CT and CT pointed out a local recurrence and liver metastases that were resected in 2004. Adjuvant imatinib at a dose of 300 mg/day was started but the dose was reduced to 300 mg/2 days due to a side effect. Resumption and discontinuation of imatinib had been repeated. In 2008, he received a resection of mediastinal pleural metastasis. Imatinib started again at a dose of 200 mg/2 days and no recurrence has been pointed out. Combined modality therapy with surgery and chemotherapy for the metastatic GIST may contribute to a long-term survival.
authors.affiliation: Department of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine.
authors.forename: Masahito
authors.initials: M
authors.lastname: Tsutsui
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Oka
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D010997:Pleural Neoplasms / Q000556:secondary*; D011743:Pyrimidines / Q000008:administration & dosage / Q000627:therapeutic use*; D012004:Rectal Neoplasms / Q000601:surgery / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate