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

Cited 2 time in Web of Science Cited 1 time in Scopus

Kong, Seong-Ho; Kurokawa, Yukinori; Yook, Jeong-Hwan; Cho, Haruhiko; Kwon, Oh-Kyoung; Masuzawa, Toru; Lee, Kyung Hee; Matsumoto, Sohei; Park, Young Soo; Honda, Hiroshi; Ryu, Seung-Wan; Ishikawa, Takashi; Kang, Hye Jin; Nabeshima, Kazuhito; Im, Seock-Ah; Shimokawa, Toshio; Kang, Yoon-Koo; Hirota, Seiichi; Yang, Han-Kwang; Nishida, Toshirou

Issue Date
GASTRIC CANCER, Vol.26 No.5, pp.775-787
BackgroundNeoadjuvant 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.MethodsPatients with large (& GE; 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.ResultsA 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.ConclusionsNeoadjuvant 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.
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  • College of Medicine
  • Department of Medicine
Research Area Clinical Medicine


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