Surgical interventions for focal progression of advanced gastrointestinal stromal tumors during imatinib therapy

Hasegawa, Junichi; Kanda, Tatsuo; Hirota, Seiichi; Fukuda, Masafumi; Nishitani, Akiko; Takahashi, Tsuyoshi; Kurosaki, Isao; Tsutsui, Shusaku; Hatakeyama, Katsuyoshi; Nishida, Toshirou

doi:10.1007/s10147-007-0657-y

Cited by 57 publications

(29 citation statements)

References 19 publications

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“…There are a few nonrandomized retrospective studies of the indications, safety, and prognostic benefi ts of surgical treatments for focally imatinib-resistant GIST. 44,48,49 When surgery is performed for focally resistant GIST, followed by imatinib continuation, substantial safety of the procedure and prolonged PFS for 6-8 months have been reported. 44,48,49 The clinical effect on OS, however, is unknown, and this treatment is being subjected to detailed investigation at special hospitals and institutions.…”

Section: Imatinib-resistant Gistmentioning

confidence: 98%

Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version

et al. 2008

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Diagnostic and treatment strategies for gastrointestinal stromal tumors (GISTs) have evolved greatly since the introduction of molecularly targeted therapies. Although several clinical practice guidelines are extant, such as those published by the National Comprehensive Cancer Network and the European Society of Medical Oncology, it is not clear as to whether these are appropriate for clinical practice in Japan. Therefore, clinical practice guidelines for the optimal diagnosis and treatment of GIST tailored for the Japanese situation have often been requested. For this reason, the Japanese Clinical Practice Guideline for GIST was proposed by the GIST Guideline Subcommittee, with the official approval of the Clinical Practice Guidelines Committee for Cancer of the Japan Society of Clinical Oncology (JSCO), and was published after assessment by the Guideline Evaluation Committee of JSCO. The GIST Guideline Subcommittee consists of members from JSCO, the Japanese Gastric Cancer Association (JGCA), and the Japanese Study Group on GIST, with the official approval of these organizations. The GIST Guideline Subcommittee is not influenced by any other organizations or third parties. Revision of the guideline may be done periodically, with the approval of the GIST Guideline Subcommittee, either every 3 years or when important new evidence that might alter the optimal diagnosis and treatment of GIST emerges. Here we present the English version of the Japanese Clinical Practice Guideline for GIST prepared by the GIST Guideline Subcommittee.

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Section: Imatinib-resistant Gistmentioning

confidence: 98%

Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version

et al. 2008

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“…The rationale behind this approach is the elimination of drug-resistant clones that will allow ongoing therapy with imatinib [89][90][91][92][93][94] . Debulking in the form of removal of the gross tumor followed by intraperitoneal chemotherapy with cisplatin and doxorubicin or mitoxantrone have been attempted; the median time to recurrence was increased from 8 to 21 mo with the addition of intraperitoneal chemotherapy [94][95][96][97] .…”

Section: Peritoneal and Liver Metastasesmentioning

confidence: 99%

“…Surgery in metastatic patients is a case based decision. Residual tumor resection is safe but multifocal resection is not recommended without considering the patient's performance status and personal situation [29,[89][90][91] . When surgery may not be possible, limited evidence exists that similar benefits could be obtained with nonsurgical ablative techniques such as radiofrequency ablation or embolization [98][99][100] .…”

Section: Peritoneal and Liver Metastasesmentioning

confidence: 99%

A gist of gastrointestinal stromal tumors: A review

Rammohan¹,

Sathyanesan²,

Rajendran³

et al. 2012

WJGO

154

193

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enchymal tumors. Both traditional and minimally invasive surgery are used to remove these tumors with minimal morbidity and excellent perioperative outcomes. The revolutionary use of specific, molecularlytargeted therapies, such as imatinib mesylate, reduces the frequency of disease recurrence when used as an adjuvant following complete resection. Neoadjuvant treatment with these agents appears to stabilize disease in the majority of patients and may reduce the extent of surgical resection required for subsequent complete tumor removal. The important interplay between the molecular genetics of GIST and responses to targeted therapeutics serves as a model for the study of targeted therapies in other solid tumors. This review summarizes our current knowledge and recent advances regarding the histogenesis, pathology, molecular biology, the basis for the novel targeted cancer therapy and current evidence based management of these unique tumors. AbstractGastrointestinal stromal tumors (GISTs)

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“…In addition, the broad selection of second-line treatments may lead to good prognosis in patients with ISR because a small PD is generally treatable by local therapies, such as surgery and IVR. Our previous study on the surgical resection of imatinib-resistant GISTs revealed that the rate of complete resection of small tumors (<5 cm in diameter) was higher than that of large tumors (≥5 cm in diameter) [23]. Furthermore, the lead-time bias in which earlier detection could apparently result in longer survival should be taken into consideration in such a retrospective study.…”

Section: Discussionmentioning

confidence: 98%

Prognostic factors after imatinib secondary resistance: survival analysis in patients with unresectable and metastatic gastrointestinal stromal tumors

et al. 2015

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Surgical interventions for focal progression of advanced gastrointestinal stromal tumors during imatinib therapy

Abstract: Our study indicates that surgical interventions in patients with GIST resistant to imatinib therapy are efficacious when complete resections are performed, when the lesions are of gastric origin, when the number of lesions is lower, and when the lesions are a smaller size.

Cited by 57 publications

References 19 publications

Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version

Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version

A gist of gastrointestinal stromal tumors: A review

Prognostic factors after imatinib secondary resistance: survival analysis in patients with unresectable and metastatic gastrointestinal stromal tumors

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