[An update of the surgical indications for gastrointestinal stromal tumors]

Complete resection without tumor rupture remains the mainstay of the treatment in patients with localized, resectable GIST. Operative indications should take account of size and location of the tumor which impact the risk of recurrence. More micro-GIST are discovered with the development of investigations, rising the question of wait and see policy for some of them. In locally advanced inoperable patients and metastatic patients, Imatinib is the standard treatment. Secondary excision of residual disease has been shown to be related to a good prognosis in responding patients to imatinib, but it is still not demonstrated whether this is due to surgery itself or to a selection bias. A phase 3 EORTC study will start and will randomise this secondary surgery after 6 to 12 months of imatinib in responding patients.