Clinical presentation and treatment of gastrointestinal stromal tumors

Tumori. 2006 Jul-Aug;92(4):279-84. doi: 10.1177/030089160609200403.

Abstract

Aims and background: Gastrointestinal stromal tumors (GISTs), although rare, are the most common mesenchymal neoplasms affecting the gastrointestinal tract. We present our experience in the treatment of localized and metastatic disease and a review of literature.

Patients and methods: Nine patients were observed from April 2002 to July 2004. Eight tumors were in the gastric area and 1 was in the small bowel. In 5 cases, complete surgical removal was performed, and none of these patients underwent adjuvant therapy. The remaining 4 cases, with locally advanced or recurrent disease, were treated with imatinib.

Results: The patients with localized disease treated only by surgery did not relapse. In the patients with locally advanced or metastatic disease treated by imatinib, we observed 3 partial responses, and one case was not assessable because he had no measurable disease. In 2 of 3 responders, it was possible to perform a new radical surgery.

Conclusions: Our series is too small to draw any conclusion. According to our review of the literature, surgery remains the standard treatment for non-metastatic GISTs. Imatinib mesylate represents a major breakthrough in the treatment of advanced GISTs and is the first effective systemic therapy for the disease.

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Benzamides
  • Chemotherapy, Adjuvant
  • Female
  • Gastrointestinal Stromal Tumors / diagnosis*
  • Gastrointestinal Stromal Tumors / drug therapy
  • Gastrointestinal Stromal Tumors / surgery
  • Gastrointestinal Stromal Tumors / therapy*
  • Humans
  • Imatinib Mesylate
  • Male
  • Middle Aged
  • Piperazines / therapeutic use*
  • Protein Kinase Inhibitors / therapeutic use
  • Pyrimidines / therapeutic use*
  • Reoperation
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Benzamides
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyrimidines
  • Imatinib Mesylate