계명대학교 의학도서관 Repository

Long-term outcomes of a phase II study of neoadjuvant imatinib in large gastrointestinal stromal tumors of the stomach

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Author(s)
Seong-Ho KongYukinori KurokawaJeong-Hwan YookHaruhiko ChoOh-Kyoung KwonToru MasuzawaKyung Hee LeeSohei MatsumotoYoung Soo ParkHiroshi HondaSeung-Wan RyuTakashi IshikawaHye Jin KangKazuhito NabeshimaSeock-Ah ImToshio ShimokawaYoon-Koo KangSeiichi HirotaHan-Kwang YangToshirou Nishida
Keimyung Author(s)
Ryu, Seung Wan
Department
Dept. of Surgery (외과학)
Journal Title
Gastric Cancer
Issued Date
2023
Volume
26
Issue
5
Keyword
Gastrointestinal stromal tumorImatinib mesylateNeoadjuvantStomach neoplasm
Abstract
Background:
Neoadjuvant treatment is recommended for large GISTs due to their friability and risk of extensive operations; however, studies on the indications and long-term results of this approach are lacking.

Methods:
Patients with large (≥ 10 cm) gastric GISTs were enrolled from multiple centers in Korea and Japan after a pathologic confirmation of c-KIT ( +) GISTs. Imatinib (400 mg/d) was given for 6-9 months preoperatively, and R0 resection was intended. Postoperative imatinib was given for at least 12 months and recommended for 3 years.

Results:
A total of 56 patients were enrolled in this study, with 53 patients receiving imatinib treatment at least once and 48 patients undergoing R0 resection. The 5-year overall survival and progression-free survival rates were 94.3% and 61.6%, respectively. Even patients with stable disease by RECIST criteria responded well to preoperative imatinib treatment and could undergo R0 resection, with most being evaluated as partial response by CHOI criteria. The optimal reduction in tumor size was achieved with preoperative imatinib treatment for 24 weeks or more. No resumption of imatinib treatment was identified as an independent prognostic factor for recurrence after R0 resection. No additional size criteria for a higher risk of recurrence were identified in this cohort with a size of 10 cm or more.

Conclusions:
Neoadjuvant imatinib treatment is an effective treatment option for gastric GISTs 10 cm or larger. Postoperative imatinib treatment is recommended even after R0 resection to minimize recurrence.
Keimyung Author(s)(Kor)
류승완
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1436-3305
Source
https://link.springer.com/article/10.1007/s10120-023-01406-0
DOI
10.1007/s10120-023-01406-0
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45213
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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