title: Gastrointestinal stromal tumors treatment in the Imatinib era. The role of fair indication.
abstract: OBJECTIVE
  Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. Surgery remains the elective treatment. We retrospectively compared two group of patients, who underwent surgery for GIST before and after Imatinib advent in order to analyze the recurrence and survival rate.
  
  
  METHODS
  Two patient groups who underwent surgery for GIST, from January 1997 to December 2002 (Pre-Imatinib group) and from January 2003 to December 2008 (Post-Imatinib group) were compared. Patients were evaluated on the base of gender, age, clinical manifestations, primary location and metastasis positivity, tumor size, mitotic index, immunoreactivity for CD117 and the outcome, including date of death.
  
  
  RESULTS
  In the Pre-IM group only one patient died for prostate cancer, 12 months after operation, the other died because of GIST with a 24.6 months of median survival rate (range 15-51). In the remaining 12 patients the median follow up period was 55 months (range 6-152 months). In the Post-IM group the mean follow up was 50.7 months (range 26-74) and they are still being assessed for oncological as well as surgical treatment.
  
  
  CONCLUSIONS
  Early diagnosis and radical resection remain the standard of cure for GISTs. To date, the use of Imatinib lead to its utilization as adjuvant and neo-adjuvant therapy in adults. Our experience suggests that there is a correlation between the mutational status of KIT and clinical outcome. These aspects should be explored for targeted therapy that can effectively combine biological therapy to surgery.
authors.affiliation: Department of Surgical Sciences, La Sapienza University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Vendettuoli
authors.forename: D
authors.initials: D
authors.lastname: Pironi
authors.forename: S
authors.initials: S
authors.lastname: Pontone
authors.forename: A
authors.initials: A
authors.lastname: Panarese
authors.forename: G
authors.initials: G
authors.lastname: La Gioia
authors.forename: S
authors.initials: S
authors.lastname: Arcieri
authors.forename: A M
authors.initials: AM
authors.lastname: Romani
authors.forename: G
authors.initials: G
authors.lastname: Palazzini
authors.forename: A
authors.initials: A
authors.lastname: Filippini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides; D005260:Female; 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*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate