Journal
SURGERY TODAY
Volume 40, Issue 10, Pages 936-942Publisher
SPRINGER
DOI: 10.1007/s00595-009-4171-x
Keywords
Gastrointestinal stromal tumor; Surgery; Neoadjuvant therapy; Tyrosine kinase inhibitor; Imatinib
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Purpose. To evaluate the effectiveness of resecting liver metastases of gastrointestinal stromal tumors (GISTs), when performed in conjunction with imatinib treatment. Methods. Forty-one patients with pathologically diagnosed GIST and liver metastases were randomly assigned to an operation group (neoadjuvant therapy + resection + adjuvant therapy with imatinib) or a nonoperation group (imatinib alone). Patients were monitored for up to 36 months, and survival was analyzed. Results. We monitored 39 patients throughout the 36-month follow-up period, recording 1- and 3-year survival rates of 100% and 89.5% in the operation group and 85% and 60% in the nonoperation group, respectively. There was a significant difference in overall survival between the operation and nonoperation groups (P = 0.03). Furthermore, resection improved the survival of patients who responded poorly to 6 months of preoperative imatinib treatment, compared with that of their counterparts in the nonoperation group (P = 0.04). Conclusion. These findings suggest that surgical intervention in combination with imatinib treatment is more effective than imatinib alone against GIST liver metastases, with minimal complications and side effects.
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