Surgical resection of gastrointestinal stromal tumors after treatment with imatinib

Robert H I Andtbacka, Chaan S. Ng, Courtney L. Scaife, Janice N. Cormier, Kelly K. Hunt, Peter W T Pisters, Raphael E. Pollock, Robert S. Benjamin, Michael A. Burgess, Lei L. Chen, Jonathan Trent, Shreyaskumar R. Patel, Kevin Raymond, Barry W. Feig

Research output: Contribution to journalArticle

191 Citations (Scopus)

Abstract

Background: Surgical resection of gastrointestinal stromal tumors (GISTs) has been the most effective therapy for these rare tumors. Imatinib has been introduced as systemic therapy for locally advanced and metastatic GIST. In this study, the surgical resection rates and long-term outcomes of patients treated with preoperative imatinib for locally advanced primary, recurrent, or metastatic GISTs were evaluated. Methods: Patients were retrospectively assessed for completeness of surgical resection and for disease-free and overall survival after resection. Results: Forty-six patients underwent surgery after treatment with imatinib. Eleven were treated for locally advanced primary GISTs for a median of 11.9 months, followed by complete surgical resection. All eleven were alive at a median of 19.5 months, and ten were free of disease. Thirty-five patients were treated for recurrent or metastatic GIST. Of these, eleven underwent complete resection. Six of the eleven patients had recurrent disease at a median of 15.1 months. All eleven patients were alive at a median of 30.7 months. Patients with a partial radiographic tumor response to imatinib had significantly higher complete resection rates than patients with progressive disease (91% vs. 4%; P < .001). Of the 24 patients with incomplete resection, 18 initially responded to imatinib but were unable to undergo complete resection after they progressed before surgery. Conclusions: Preoperative imatinib can decrease tumor volume and is associated with complete surgical resection in locally advanced primary GISTs. Early surgical intervention should be considered for imatinib-responsive recurrent or metastatic GIST, since complete resection is rarely achieved once tumor progression occurs.

Original languageEnglish
Pages (from-to)14-24
Number of pages11
JournalAnnals of Surgical Oncology
Volume14
Issue number1
DOIs
StatePublished - Jan 1 2007
Externally publishedYes

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Gastrointestinal Stromal Tumors
Therapeutics
Imatinib Mesylate
Neoplasms
Tumor Burden
Disease-Free Survival

Keywords

  • Gastrointestinal stromal tumor
  • Imatinib
  • Outcome
  • Surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Andtbacka, R. H. I., Ng, C. S., Scaife, C. L., Cormier, J. N., Hunt, K. K., Pisters, P. W. T., ... Feig, B. W. (2007). Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Annals of Surgical Oncology, 14(1), 14-24. https://doi.org/10.1245/s10434-006-9034-8

Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. / Andtbacka, Robert H I; Ng, Chaan S.; Scaife, Courtney L.; Cormier, Janice N.; Hunt, Kelly K.; Pisters, Peter W T; Pollock, Raphael E.; Benjamin, Robert S.; Burgess, Michael A.; Chen, Lei L.; Trent, Jonathan; Patel, Shreyaskumar R.; Raymond, Kevin; Feig, Barry W.

In: Annals of Surgical Oncology, Vol. 14, No. 1, 01.01.2007, p. 14-24.

Research output: Contribution to journalArticle

Andtbacka, RHI, Ng, CS, Scaife, CL, Cormier, JN, Hunt, KK, Pisters, PWT, Pollock, RE, Benjamin, RS, Burgess, MA, Chen, LL, Trent, J, Patel, SR, Raymond, K & Feig, BW 2007, 'Surgical resection of gastrointestinal stromal tumors after treatment with imatinib', Annals of Surgical Oncology, vol. 14, no. 1, pp. 14-24. https://doi.org/10.1245/s10434-006-9034-8
Andtbacka RHI, Ng CS, Scaife CL, Cormier JN, Hunt KK, Pisters PWT et al. Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Annals of Surgical Oncology. 2007 Jan 1;14(1):14-24. https://doi.org/10.1245/s10434-006-9034-8
Andtbacka, Robert H I ; Ng, Chaan S. ; Scaife, Courtney L. ; Cormier, Janice N. ; Hunt, Kelly K. ; Pisters, Peter W T ; Pollock, Raphael E. ; Benjamin, Robert S. ; Burgess, Michael A. ; Chen, Lei L. ; Trent, Jonathan ; Patel, Shreyaskumar R. ; Raymond, Kevin ; Feig, Barry W. / Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. In: Annals of Surgical Oncology. 2007 ; Vol. 14, No. 1. pp. 14-24.
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abstract = "Background: Surgical resection of gastrointestinal stromal tumors (GISTs) has been the most effective therapy for these rare tumors. Imatinib has been introduced as systemic therapy for locally advanced and metastatic GIST. In this study, the surgical resection rates and long-term outcomes of patients treated with preoperative imatinib for locally advanced primary, recurrent, or metastatic GISTs were evaluated. Methods: Patients were retrospectively assessed for completeness of surgical resection and for disease-free and overall survival after resection. Results: Forty-six patients underwent surgery after treatment with imatinib. Eleven were treated for locally advanced primary GISTs for a median of 11.9 months, followed by complete surgical resection. All eleven were alive at a median of 19.5 months, and ten were free of disease. Thirty-five patients were treated for recurrent or metastatic GIST. Of these, eleven underwent complete resection. Six of the eleven patients had recurrent disease at a median of 15.1 months. All eleven patients were alive at a median of 30.7 months. Patients with a partial radiographic tumor response to imatinib had significantly higher complete resection rates than patients with progressive disease (91{\%} vs. 4{\%}; P < .001). Of the 24 patients with incomplete resection, 18 initially responded to imatinib but were unable to undergo complete resection after they progressed before surgery. Conclusions: Preoperative imatinib can decrease tumor volume and is associated with complete surgical resection in locally advanced primary GISTs. Early surgical intervention should be considered for imatinib-responsive recurrent or metastatic GIST, since complete resection is rarely achieved once tumor progression occurs.",
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AU - Cormier, Janice N.

AU - Hunt, Kelly K.

AU - Pisters, Peter W T

AU - Pollock, Raphael E.

AU - Benjamin, Robert S.

AU - Burgess, Michael A.

AU - Chen, Lei L.

AU - Trent, Jonathan

AU - Patel, Shreyaskumar R.

AU - Raymond, Kevin

AU - Feig, Barry W.

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AB - Background: Surgical resection of gastrointestinal stromal tumors (GISTs) has been the most effective therapy for these rare tumors. Imatinib has been introduced as systemic therapy for locally advanced and metastatic GIST. In this study, the surgical resection rates and long-term outcomes of patients treated with preoperative imatinib for locally advanced primary, recurrent, or metastatic GISTs were evaluated. Methods: Patients were retrospectively assessed for completeness of surgical resection and for disease-free and overall survival after resection. Results: Forty-six patients underwent surgery after treatment with imatinib. Eleven were treated for locally advanced primary GISTs for a median of 11.9 months, followed by complete surgical resection. All eleven were alive at a median of 19.5 months, and ten were free of disease. Thirty-five patients were treated for recurrent or metastatic GIST. Of these, eleven underwent complete resection. Six of the eleven patients had recurrent disease at a median of 15.1 months. All eleven patients were alive at a median of 30.7 months. Patients with a partial radiographic tumor response to imatinib had significantly higher complete resection rates than patients with progressive disease (91% vs. 4%; P < .001). Of the 24 patients with incomplete resection, 18 initially responded to imatinib but were unable to undergo complete resection after they progressed before surgery. Conclusions: Preoperative imatinib can decrease tumor volume and is associated with complete surgical resection in locally advanced primary GISTs. Early surgical intervention should be considered for imatinib-responsive recurrent or metastatic GIST, since complete resection is rarely achieved once tumor progression occurs.

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