Liver surgery in the multidisciplinary management of gastrointestinal stromal tumour

Ferdinando C M Cananzi, Ajay Belgaumkar, Bruno Lorenzi, Satvinder Mudan

Research output: Contribution to journalArticlepeer-review

Abstract

Background: After the introduction of tyrosine kinase inhibitors (TKIs), the role of surgical resection in treating liver metastasis from gastrointestinal stromal tumour (GIST) is unclear. In this study, we evaluated the outcome of patients treated with TKIs followed by surgery for metastatic GIST. Methods: Eleven patients who underwent liver resection after downsizing TKIs therapy for metastatic GIST from 2006 until 2010 were reviewed. Results: One and 2-year overall survival (OS) rates were 80.8% and 70.7%. All patients with an initially resectable tumour were still alive without recurrence. Patients operated on clinical response had a better outcome (1-year and 2-year OS rate of 100%) than those operated on disease progression (1-year and 2-year OS rates of 60% and 40%; P=0.043). No deaths were observed among patients who achieved an R0 resection (R0 versus R1/R2, P=0.001). Conclusion: R0 resection and clinical response to TKI are predictors of survival. Surgical resection should be performed as soon as feasible in responder patients. In poor responders, surgery may not add any survival benefit, except in localized progressive disease. In resectable metastatic liver disease, preoperative TKIs or upfront surgery followed by adjuvant therapy could be considered. Larger studies are needed to determine the optimum approach in patients with metastatic GIST.

Original languageEnglish
Pages (from-to)937-942
Number of pages6
JournalANZ Journal of Surgery
Volume84
Issue number12
DOIs
Publication statusPublished - 2014

Keywords

  • GIST
  • Imatinib
  • Liver metastases
  • Liver resection
  • Preoperative therapy

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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