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Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report
Therapeutic decision-making for advanced GIST liver metastases is challenging due to limited clinical evidence. This case study aims to demonstrate the survival benefit of resection in non-responsive cases. A 40-year-old male presented with abdominal pain, weight loss, altered general status, massiv...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456077/ https://www.ncbi.nlm.nih.gov/pubmed/37629538 http://dx.doi.org/10.3390/life13081681 |
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author | Kraft, Alin Moldovan, Cosmin Bârcu, Alexandru Dumitru, Radu Croitoru, Adina Herlea, Vlad Popescu, Irinel Botea, Florin |
author_facet | Kraft, Alin Moldovan, Cosmin Bârcu, Alexandru Dumitru, Radu Croitoru, Adina Herlea, Vlad Popescu, Irinel Botea, Florin |
author_sort | Kraft, Alin |
collection | PubMed |
description | Therapeutic decision-making for advanced GIST liver metastases is challenging due to limited clinical evidence. This case study aims to demonstrate the survival benefit of resection in non-responsive cases. A 40-year-old male presented with abdominal pain, weight loss, altered general status, massive hepatomegaly, and intermittent melaena. He was diagnosed with stage IV GIST with the primary tumor in the ileal loop and multiple gigantic synchronous bilobar liver metastases. Despite 31 months of tyrosine-kinase inhibitor therapy post-primary tumor resection, the disease remained unresponsive. The patient was admitted to our tertiary center with significant hepatomegaly. A two-stage debulking liver resection was performed after a multidisciplinary team decision. The first operation debulked the left hemiliver through a non-anatomical ultrasound-guided resection of segments 2, 3, and 4. The second operation (7 weeks later) debulked the right hemiliver through a right posterior sectionectomy involving segments 5 and 8. Despite receiving a second line of tyrosine-kinase inhibitor therapy after surgery, the disease progressed both within and outside the liver. However, the patient survived for 55 months, with a postoperative survival benefit of 25 months. In conclusion, this case emphasizes the significant survival benefit achieved through a complex two-stage debulking liver resection for giant liver metastases, even in cases where systemic therapy fails. |
format | Online Article Text |
id | pubmed-10456077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104560772023-08-26 Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report Kraft, Alin Moldovan, Cosmin Bârcu, Alexandru Dumitru, Radu Croitoru, Adina Herlea, Vlad Popescu, Irinel Botea, Florin Life (Basel) Case Report Therapeutic decision-making for advanced GIST liver metastases is challenging due to limited clinical evidence. This case study aims to demonstrate the survival benefit of resection in non-responsive cases. A 40-year-old male presented with abdominal pain, weight loss, altered general status, massive hepatomegaly, and intermittent melaena. He was diagnosed with stage IV GIST with the primary tumor in the ileal loop and multiple gigantic synchronous bilobar liver metastases. Despite 31 months of tyrosine-kinase inhibitor therapy post-primary tumor resection, the disease remained unresponsive. The patient was admitted to our tertiary center with significant hepatomegaly. A two-stage debulking liver resection was performed after a multidisciplinary team decision. The first operation debulked the left hemiliver through a non-anatomical ultrasound-guided resection of segments 2, 3, and 4. The second operation (7 weeks later) debulked the right hemiliver through a right posterior sectionectomy involving segments 5 and 8. Despite receiving a second line of tyrosine-kinase inhibitor therapy after surgery, the disease progressed both within and outside the liver. However, the patient survived for 55 months, with a postoperative survival benefit of 25 months. In conclusion, this case emphasizes the significant survival benefit achieved through a complex two-stage debulking liver resection for giant liver metastases, even in cases where systemic therapy fails. MDPI 2023-08-03 /pmc/articles/PMC10456077/ /pubmed/37629538 http://dx.doi.org/10.3390/life13081681 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Kraft, Alin Moldovan, Cosmin Bârcu, Alexandru Dumitru, Radu Croitoru, Adina Herlea, Vlad Popescu, Irinel Botea, Florin Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report |
title | Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report |
title_full | Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report |
title_fullStr | Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report |
title_full_unstemmed | Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report |
title_short | Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report |
title_sort | salvage hepatectomy for giant gist liver metastases unresponsive to systemic therapy—case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456077/ https://www.ncbi.nlm.nih.gov/pubmed/37629538 http://dx.doi.org/10.3390/life13081681 |
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