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Updated: May 14, 2026
Robotic Duodenal Sleeve Resection for Gastrointestinal Stromal Tumor with Rare Exon 8 KIT Mutation Following Neoadjuvant Imatinib
Published on: April 3, 2026
Imatinib as preoperative therapy in Chinese patients with recurrent or metastatic GISTs
Chunmeng Wang1, Biqiang Zheng, Yong Chen
1Gastric Cancer and Soft Tissue Sarcoma Department, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
Objective:
Imatinib has dramatically altered the options for management of patients with gastrointestinal stromal tumours. However, it has become clear that secondary resistance to the drug develops during long-term therapy. The purpose of our study was to retrospectively analyze safety and long-term outcomes in Chinese patients with recurrent or metastatic GISTs treated with imatinib preoperatively.
Methods:
Between June 2003 and June 2011, 22 patients underwent surgery for recurrent or metastatic GISTs after preoperative treatment with imatinib.
Results:
Complete resection was accomplished in 8 of the 10 responsive disease (RD) patients (80%), and in 3 of the 12 patients (25%) who had progression disease (PD). The amount of blood loss during the operation in PD patients was higher than in RD patients. There was 1 hospital death in PD group related to surgery, while the other patients recovered with conservative therapy because complications were mild. The difference in median PFS between patients with RD and those with PD was significant (24.8 vs. 2.81 months, P<0.001). The difference in 2-year OS rate between patients with RD and those with PD was not significant (100% vs. 87.5%, P>0.05).
Conclusions:
Our study indicates that surgical intervention can improve the PFS of Chinese patients with recurrent or metastatic GISTs responsive to imatinib, but does not prolong OS as well as in patients who develop imatinib resistance. Surgical resection following imatinib treatment is feasible and can be considered for patients with advanced GISTs responsive to imatinib.
Insights
Surgical resection after imatinib treatment improved progression-free survival (PFS) in Chinese patients with gastrointestinal stromal tumors (GISTs) responsive to therapy. However, overall survival (OS) was not significantly prolonged, especially in patients with imatinib resistance.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Imatinib therapy has revolutionized gastrointestinal stromal tumor (GIST) management.
- Secondary resistance to imatinib is a significant challenge in long-term GIST treatment.
- Understanding outcomes of surgical intervention post-imatinib is crucial for advanced GISTs.
Purpose of the Study:
- To retrospectively analyze the safety and long-term outcomes of preoperative imatinib treatment followed by surgery in Chinese patients with recurrent or metastatic GISTs.
- To evaluate the impact of imatinib response on surgical outcomes and survival.
Main Methods:
- Retrospective analysis of 22 Chinese patients with recurrent or metastatic GISTs treated with imatinib preoperatively between June 2003 and June 2011.
- Surgical resection was performed after neoadjuvant imatinib therapy.
- Outcomes including resection rates, blood loss, complications, progression-free survival (PFS), and overall survival (OS) were assessed.
Main Results:
- Complete resection rates were 80% in imatinib-responsive disease (RD) and 25% in progressive disease (PD) patients.
- PD patients experienced higher intraoperative blood loss and one surgery-related death.
- Median PFS was significantly longer in RD patients (24.8 months) compared to PD patients (2.81 months; P<0.001).
- Two-year OS rates were 100% for RD and 87.5% for PD patients (P>0.05).
Conclusions:
- Surgical intervention following imatinib treatment can enhance PFS in Chinese GIST patients with responsive disease.
- Surgical resection is feasible for advanced GISTs, particularly in patients responding to imatinib.
- Imatinib resistance may limit the overall survival benefit of surgical intervention in recurrent or metastatic GISTs.
