Imatinib as Preoperative Therapy for Primary Large Gastrointestinal Stromal Tumor

Abstract

Aim: This study aimed to explore whether preoperative imatinib mesylate (IM) can improve the surgical safety and prognosis of patients with large gastrointestinal stromal tumor (GIST). Methods: Patients with large GIST in a single medical institution (Department of General Surgery, West China Hospital, Sichuan University, China) from February 2007 to November 2011 participated in this study. Patients were divided into two groups (preoperative treatment group and control group) based on whether they have taken IM preoperatively. All patients underwent laparotomy and postoperative adjuvant therapy. Recurrence/metastasis-free survival (RFS) and overall survival (OS) were calculated based on Kaplan–Meier analysis. Results: A total of 50 patients were enrolled in this study, of whom 17 patients were classified in the preoperative treatment group and 33 patients were in the control group. No significant differences in clinical pathologic features and demographic data before starting any treatment (P>0.05) were observed between the two groups. The preoperative treatment group was superior to the control group with respect to intraoperative bleeding volume, multivisceral resection rate, and R0 resection rate (P<0.05). Lower recurrence or metastasis rates were reported in patients in the preoperative treatment group compared with those in the control group two years after surgery (P=0.026). However, no statistically significant difference was observed in the two-year OS between the two groups (P=0.347). Conclusions: Preoperative IM in patients with large GIST was safe and feasible. Moreover, preoperative IM could reduce the intraoperative bleeding volume and multivisceral resection rate, and improve the R0 resection rate. It also significantly improved the RFS at two years post-operation.