[Surgical treatment of an advanced GIST the age of imatinib]

The use of imatinib in the management of gastrointestinal stromal tumours has radically changed their prognosis, particularly in their advanced forms, whether they are metastasic (the majority) or locally advanced. The high rates of response obtained means that, in many cases, surgery can be performed in situations where it was impossible to do so, even to the extent of considering surgery as a first line therapeutic weapon in combination with imatinib. Even so, it must not be used indiscriminately. It will be the different responses of these tumours to imatinib that will determine its usefulness and the way it is used. The combined use of surgery and imatinib is a clear and successful example of multimodal treatment in the context of the so-called targeted molecular therapy.