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Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective

BACKGROUND: Surgical resection has remained the mainstay of treatment of GIST with a 5-year-survival of 28–35%. Tyrosine kinase inhibitor (Imatinib) has revolutionised the treatment of these tumours. The current research is directed towards expanding the role of this drug in the treatment of GIST. W...

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Autores principales: Date, Ravindra S, Stylianides, Nicholas A, Pursnani, Kishore G, Ward, Jeremy B, Mughal, Muntzer M
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491627/
https://www.ncbi.nlm.nih.gov/pubmed/18644105
http://dx.doi.org/10.1186/1477-7819-6-77
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author Date, Ravindra S
Stylianides, Nicholas A
Pursnani, Kishore G
Ward, Jeremy B
Mughal, Muntzer M
author_facet Date, Ravindra S
Stylianides, Nicholas A
Pursnani, Kishore G
Ward, Jeremy B
Mughal, Muntzer M
author_sort Date, Ravindra S
collection PubMed
description BACKGROUND: Surgical resection has remained the mainstay of treatment of GIST with a 5-year-survival of 28–35%. Tyrosine kinase inhibitor (Imatinib) has revolutionised the treatment of these tumours. The current research is directed towards expanding the role of this drug in the treatment of GIST. We present our experience of managing GIST in this institute. METHODS: This is a case note study of patients identified from a prospectively kept database from January 2000 to August 2007. RESULTS: 16 patients were diagnosed with GIST. The median age was 66 years (range 46 to 82) and the male to female ratio was 9:7. Eleven patients underwent surgery, 9 of which had R0 resection (2 laparoscopic, 1 converted to open), one had an open biopsy and one had a debulking procedure. 3 patients were inoperable and 2 were found to be unfit for surgery. Five patients received Imatinib (2 postoperatively). The risk assessment based on morphological criteria showed that 4 patients had low, 4 had intermediate and 8 had high malignant potential. The median follow up was for 12 months (range 3–72); 2 patients died of unrelated causes at 6 and 9 months after diagnosis. CONCLUSION: Most GISTs can be managed effectively using existing protocols. However currently there is no evidence based guidance available on the management of GIST in the following situations-role of debulking surgery, the follow up of benign tumours not requiring surgical resection and role of laparoscopic surgery. Further research is needed to answer these questions.
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spelling pubmed-24916272008-07-31 Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective Date, Ravindra S Stylianides, Nicholas A Pursnani, Kishore G Ward, Jeremy B Mughal, Muntzer M World J Surg Oncol Research BACKGROUND: Surgical resection has remained the mainstay of treatment of GIST with a 5-year-survival of 28–35%. Tyrosine kinase inhibitor (Imatinib) has revolutionised the treatment of these tumours. The current research is directed towards expanding the role of this drug in the treatment of GIST. We present our experience of managing GIST in this institute. METHODS: This is a case note study of patients identified from a prospectively kept database from January 2000 to August 2007. RESULTS: 16 patients were diagnosed with GIST. The median age was 66 years (range 46 to 82) and the male to female ratio was 9:7. Eleven patients underwent surgery, 9 of which had R0 resection (2 laparoscopic, 1 converted to open), one had an open biopsy and one had a debulking procedure. 3 patients were inoperable and 2 were found to be unfit for surgery. Five patients received Imatinib (2 postoperatively). The risk assessment based on morphological criteria showed that 4 patients had low, 4 had intermediate and 8 had high malignant potential. The median follow up was for 12 months (range 3–72); 2 patients died of unrelated causes at 6 and 9 months after diagnosis. CONCLUSION: Most GISTs can be managed effectively using existing protocols. However currently there is no evidence based guidance available on the management of GIST in the following situations-role of debulking surgery, the follow up of benign tumours not requiring surgical resection and role of laparoscopic surgery. Further research is needed to answer these questions. BioMed Central 2008-07-18 /pmc/articles/PMC2491627/ /pubmed/18644105 http://dx.doi.org/10.1186/1477-7819-6-77 Text en Copyright © 2008 Date et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Date, Ravindra S
Stylianides, Nicholas A
Pursnani, Kishore G
Ward, Jeremy B
Mughal, Muntzer M
Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective
title Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective
title_full Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective
title_fullStr Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective
title_full_unstemmed Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective
title_short Management of gastrointestinal stromal tumours in the Imatinib era: a surgeon's perspective
title_sort management of gastrointestinal stromal tumours in the imatinib era: a surgeon's perspective
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491627/
https://www.ncbi.nlm.nih.gov/pubmed/18644105
http://dx.doi.org/10.1186/1477-7819-6-77
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