Abstract
Surgery is the standard treatment for a primary gastrointestinal stromal tumor (GIST); however, surgical resection is often not curative, particularly for large GISTs. In the past decade, with imatinib mesylate (IM), management strategies for GISTs have evolved significantly, and now IM is the standard care for patients with locally advanced, recurrent or metastatic GISTs. Adjuvant therapy with imatinib was recently approved for use, and preoperative imatinib is an emerging treatment option for patients who require cytoreductive therapy. IM neoadjuvant therapy for primary GISTs has been reported, but there is no consensus on the dose of the drug, the duration of treatment and the optimal time of surgery. These are critical because drug resistance or tumor progression can develop with a prolonged treatment. This report describes two cases of large rectal malignant GISTs, for which a abdominoperineal resection was initially anticipated. The two patients received IM preoperative treatment; we followed-up with CT or magnetic resonance imaging to access the response. After 9 months of treatment, a multi-disciplinary consensus that maximal benefit from imatinib had been achieved was reached. We determined the best time for surgical intervention and successfully performed sphincter-preserving surgery before resistance to imatinib or tumor progression occurred. We believe that a multidisciplinary team approach, considerating the optimal duration of therapy and the timing of surgery, is required to optimize treatment outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 147-152 |
| Number of pages | 6 |
| Journal | Journal of the Korean Society of Coloproctology |
| Volume | 27 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2011 Jun 30 |
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All Science Journal Classification (ASJC) codes
- Gastroenterology
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Efficacy of imatinib mesylate neoadjuvant treatment for a locally advanced rectal gastrointestinal stromal tumor. / Yoon, Kyu Jong; Kim, Nam Kyu; Lee, Kang Young; Min, Byung Soh; Hur, Hyuk; Kang, Jeonghyun; Lee, Sarah.
In: Journal of the Korean Society of Coloproctology, Vol. 27, No. 3, 30.06.2011, p. 147-152.Research output: Contribution to journal › Article
TY - JOUR
T1 - Efficacy of imatinib mesylate neoadjuvant treatment for a locally advanced rectal gastrointestinal stromal tumor
AU - Yoon, Kyu Jong
AU - Kim, Nam Kyu
AU - Lee, Kang Young
AU - Min, Byung Soh
AU - Hur, Hyuk
AU - Kang, Jeonghyun
AU - Lee, Sarah
PY - 2011/6/30
Y1 - 2011/6/30
N2 - Surgery is the standard treatment for a primary gastrointestinal stromal tumor (GIST); however, surgical resection is often not curative, particularly for large GISTs. In the past decade, with imatinib mesylate (IM), management strategies for GISTs have evolved significantly, and now IM is the standard care for patients with locally advanced, recurrent or metastatic GISTs. Adjuvant therapy with imatinib was recently approved for use, and preoperative imatinib is an emerging treatment option for patients who require cytoreductive therapy. IM neoadjuvant therapy for primary GISTs has been reported, but there is no consensus on the dose of the drug, the duration of treatment and the optimal time of surgery. These are critical because drug resistance or tumor progression can develop with a prolonged treatment. This report describes two cases of large rectal malignant GISTs, for which a abdominoperineal resection was initially anticipated. The two patients received IM preoperative treatment; we followed-up with CT or magnetic resonance imaging to access the response. After 9 months of treatment, a multi-disciplinary consensus that maximal benefit from imatinib had been achieved was reached. We determined the best time for surgical intervention and successfully performed sphincter-preserving surgery before resistance to imatinib or tumor progression occurred. We believe that a multidisciplinary team approach, considerating the optimal duration of therapy and the timing of surgery, is required to optimize treatment outcome.
AB - Surgery is the standard treatment for a primary gastrointestinal stromal tumor (GIST); however, surgical resection is often not curative, particularly for large GISTs. In the past decade, with imatinib mesylate (IM), management strategies for GISTs have evolved significantly, and now IM is the standard care for patients with locally advanced, recurrent or metastatic GISTs. Adjuvant therapy with imatinib was recently approved for use, and preoperative imatinib is an emerging treatment option for patients who require cytoreductive therapy. IM neoadjuvant therapy for primary GISTs has been reported, but there is no consensus on the dose of the drug, the duration of treatment and the optimal time of surgery. These are critical because drug resistance or tumor progression can develop with a prolonged treatment. This report describes two cases of large rectal malignant GISTs, for which a abdominoperineal resection was initially anticipated. The two patients received IM preoperative treatment; we followed-up with CT or magnetic resonance imaging to access the response. After 9 months of treatment, a multi-disciplinary consensus that maximal benefit from imatinib had been achieved was reached. We determined the best time for surgical intervention and successfully performed sphincter-preserving surgery before resistance to imatinib or tumor progression occurred. We believe that a multidisciplinary team approach, considerating the optimal duration of therapy and the timing of surgery, is required to optimize treatment outcome.
UR - http://www.scopus.com/inward/record.url?scp=80051484022&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80051484022&partnerID=8YFLogxK
U2 - 10.3393/jksc.2011.27.3.147
DO - 10.3393/jksc.2011.27.3.147
M3 - Article
C2 - 21829770
AN - SCOPUS:80051484022
VL - 27
SP - 147
EP - 152
JO - Annals of Coloproctology
JF - Annals of Coloproctology
SN - 2287-9714
IS - 3
ER -