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[Gastrointestinal stromal tumors].

P Hohenberger1

  • 1Sektion Chirurgische Onkologie und Thoraxchirurgie, Chirurgische Universitätsklinik, Fakultät Klinische Medizin Mannheim der Universität Heidelberg. hohenberger@sarkome.de

Praxis
|January 30, 2007
PubMed
Summary

Gastro-intestinal stromal tumors (GIST) are abdominal sarcomas. Imatinib mesylate is effective for metastatic GIST, while surgery is key for primary tumors, with adjuvant treatment under investigation.

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Area of Science:

  • Oncology
  • Gastroenterology

Background:

  • Gastro-intestinal stromal tumors (GIST) are abdominal sarcomas defined by c-kit proto-oncogen (CD117) mutations.
  • Metastatic spread typically involves the peritoneal cavity and liver, rarely lymph nodes.

Purpose of the Study:

  • To outline current treatment strategies for GIST, focusing on surgical resection and targeted therapy.
  • To discuss the role of imatinib mesylate in managing metastatic GIST and potential neoadjuvant applications.

Main Methods:

  • Review of established treatment protocols for primary and metastatic GIST.
  • Discussion of risk stratification based on tumor size and mitotic activity.
  • Consideration of surgical resection for residual disease after remission.

Main Results:

  • Complete surgical removal (R0 resection) is the primary goal for localized GIST.
  • Imatinib mesylate demonstrates high efficacy in treating metastatic GIST.
  • Systemic chemotherapy and radiation are generally ineffective for GIST.

Conclusions:

  • Imatinib is crucial for metastatic GIST; preoperative imatinib may benefit patients needing extensive resection.
  • Adjuvant treatment efficacy is under investigation in ongoing clinical trials.
  • Resection of residual lesions or progressive disease can be considered in select patients on imatinib.

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