title: Pancreas preserving surgery for duodenal gastrointestinal stromal tumor removal.
abstract: BACKGROUND
  We reported our experience with high-risk, non-metastatic second portion duodenal gastrointestinal stromal tumor (GIST)s in patients who underwent 1-month neoadjuvant cycles with imatinib therapy followed by pancreas-preserving surgery and 12-month of adjuvant chemotherapic regimen including imatinib. This study was conducted to evaluate the short and long-term results.
  
  
  METHODS
  The study was conducted between January 2010 and May 2015. Medical charts and operative logbooks of patients were retrospectively reviewed.
  
  
  RESULTS
  Nine patients form the basis of the current analysis. All patients underwent curative resection with pancreas preservation, and all specimens had histologically negative margins. The median follow-up was 35 months. Eight patients were alive, 1 patient died for myocardial infarction at a mean follow-up of 10 months, 1 patient had a recurrence at a mean follow-up of 32 months and no patients developed distant metastases.
  
  
  CONCLUSIONS
  We are confident to suggest the use of neoadjuvant and adjuvant Imatinib therapy to those patients affected with D2, high-risk, duodenal GISTs to allow a limited resection.
authors.affiliation: Department of Surgery "Pietro Valdoni", Sapienza University of Rome, Rome, Italy - danielecrocetti@hotmail.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Crocetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Sapienza
authors.forename: Claudio
authors.initials: C
authors.lastname: Cisano
authors.forename: Mariarita
authors.initials: M
authors.lastname: Tarallo
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.forename: Luigi
authors.initials: L
authors.lastname: Venturini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pedullà
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Toma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D004379:Duodenal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006785:Hospitals, University; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D010179:Pancreas / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate