Imatinib as preoperative therapy in Chinese patients with recurrent or metastatic GISTs.
OBJECTIVE
Imatinib has dramatically altered the options for management of patients with gastrointestinal stromal tumours. However, it has become clear that secondary resistance to the drug develops during long-term therapy. The purpose of our study was to retrospectively analyze safety and long-term outcomes in Chinese patients with recurrent or metastatic GISTs treated with imatinib preoperatively.


METHODS
Between June 2003 and June 2011, 22 patients underwent surgery for recurrent or metastatic GISTs after preoperative treatment with imatinib.


RESULTS
Complete resection was accomplished in 8 of the 10 responsive disease (RD) patients (80%), and in 3 of the 12 patients (25%) who had progression disease (PD). The amount of blood loss during the operation in PD patients was higher than in RD patients. There was 1 hospital death in PD group related to surgery, while the other patients recovered with conservative therapy because complications were mild. The difference in median PFS between patients with RD and those with PD was significant (24.8 vs. 2.81 months, P<0.001). The difference in 2-year OS rate between patients with RD and those with PD was not significant (100% vs. 87.5%, P>0.05).


CONCLUSIONS
Our study indicates that surgical intervention can improve the PFS of Chinese patients with recurrent or metastatic GISTs responsive to imatinib, but does not prolong OS as well as in patients who develop imatinib resistance. Surgical resection following imatinib treatment is feasible and can be considered for patients with advanced GISTs responsive to imatinib.
Gastric Cancer and Soft Tissue Sarcoma Department, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Chunmeng
C
Wang
Biqiang
B
Zheng
Yong
Y
Chen
Xi
X
Cao
Ruming
R
Zhang
Yingqiang
Y
Shi
Gastrointestinal stromal tumor; imatinib; pathology; surgical intervention; targeted therapy