title: [Application of perioperative imatinib mesylate therapy in initial resectable primary local advanced gastrointestinal stromal tumor at intermediate or high risk].
abstract: OBJECTIVE
  To evaluate the effect of perioperative imatinib mesylate (IM) therapy for patients with initial resectable primary local advanced gastrointestinal stromal tumor (GIST) at intermediate or high risk on R0 resection rate and the prognosis.
  
  
  METHODS
  Forty-eight above GIST patients between December 2001 and February 2012 were divided into 2 groups: neoadjuvant group (15 cases, pre- and post-operation IM therapy) and adjuvant group (33 cases, post-operative IM therapy). R0 resection rate, complication rate, disease-free survival (DFS) and overall survival (OS) were analyzed and compared between the two groups.
  
  
  RESULTS
  The maximal tumor diameter and average tumor diameter were larger in neoadjuvant group as compared to adjuvant group (11.2 cm vs. 7.7 cm, P=0.005; 9.1 cm vs. 6.2 cm, P=0.014). The response rate of preoperative IM therapy was 93.3% (14/15). The R0 resection rate was 86.7% and 84.8% (P=1.000), and the complication rate was 13.3% and 9.1% (P=0.642) in neoadjuvant and adjuvant group respectively. The 3-year DFS was 55% and 41% (P=0.935), and 5-year OS was 83% and 75% (P=0.766) in neoadjuvant and adjuvant group respectively.
  
  
  CONCLUSIONS
  Resectable primary local advanced GIST at intermediate or high risk with larger tumor diameter receiving perioperative IM therapy can achieve the same R0 resection rate, complication rate, DFS and OS as the GIST with smaller diameter receiving operation first. Perioperative IM therapy has potential advantage.
authors.affiliation: Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Beijing Cancer Hospital and Institute, Peking University School of Oncology, Beijing 100142, China. ligregory369@hotmail.com
authors.forename: Shuang-xi
authors.initials: SX
authors.lastname: Li
authors.forename: Zi-yu
authors.initials: ZY
authors.lastname: Li
authors.forename: Lian-hai
authors.initials: LH
authors.lastname: Zhang
authors.forename: Zhao-de
authors.initials: ZD
authors.lastname: Bu
authors.forename: Ai-wen
authors.initials: AW
authors.lastname: Wu
authors.forename: Xiao-jiang
authors.initials: XJ
authors.lastname: Wu
authors.forename: Xiang-long
authors.initials: XL
authors.lastname: Zong
authors.forename: Fei
authors.initials: F
authors.lastname: Shan
authors.forename: Xin
authors.initials: X
authors.lastname: Ji
authors.forename: Jia-fu
authors.initials: JF
authors.lastname: Ji
mesh_terms: D000328:Adult; D000368:Aged; D001549:Benzamides / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy*; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010879:Piperazines / Q000627:therapeutic use*; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate