[New surgical approaches to localized and advanced gastrointestinal stromal tumors (GIST)]

Complete resection without tumor rupture remains the mainstay of treatment for patients with localized, resectable GIST The surgical indications should take into account the size and location of the tumor, both of which influence the risk of recurrence. More micro-GISTs are being discovered with more frequent investigations, raising the question of a wait-and-see policy for some patients. Imatinib is the standard treatment for patients with locally advanced inoperable and metastatic tumors. Secondary excision of residual disease has been linked to a better prognosis in patients who respond to imatinib, but it is unclear whether this is due to the surgery itself or to a selection bias. The EORTC trial, designed to resolve this issue, was closed because of low accrual.