J.Jpn. Surg. Soc.. 118(6): 646-650, 2017

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Feature topic

GASTROINTESTINAL STROMAL TUMORS

Gastrointestinal stromal tumors (GISTs) were the first solid cancers treated with molecular-targeted agents. In the era of tyrosine-kinase inhibitors, complete surgical resection could be the only therapeutic modality to achieve cure for patients with primary GISTs. For locally advanced disease and/or high-risk GISTs, imatinib neoadjuvant therapy and/or adjuvant therapy have been established based on significant clinical evidence, respectively. Unlike those localized GISTs, however, there is no clear evidence to establish multidisciplinary approaches for the treatment of metastatic/recurrent GISTs. Whether surgical interventions have prognostic impacts, when surgery is recommended to maximize the prognostic benefit, and which patients would be the best candidates remain controversial. Multidisciplinary approaches are believed necessary to improve the prognosis of patients with advanced GISTs, although at present this must be considered individually according to each case.

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