Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate

Suzuki, Seiji; Sasajima, Koji; Miyamoto, Masayuki; Watanabe, Hidehiro; Yokoyama, Tadashi; Maruyama, Hiroshi; Matsutani, Takeshi; Liu, Aimin; Hosone, Masaru; Maeda, Shotaro; Tajiri, Takashi

doi:10.3748/wjg.14.3763

Cited by 8 publications

(12 citation statements)

References 17 publications

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“…Similarly, Suzuki et al reported a case of pCR in GIST with imatinib that did not correlate with clinical or radiological response. This result was documented in a metastatic GIST that was subjected to hepatectomy for cystic lesions in both hepatic lobes [15]. In a series of 159 metastatic GISTs, 38 patients had a partial response with imatinib and underwent an operation.…”

Section: Discussionmentioning

confidence: 92%

“…Despite the long period of treatment until surgery (15 months), our patient did not develop such resistance. Other series have reported treatment durations of up to 35 months before surgery [15]. Another issue in GIST treatment is the predictive value of conventional imaging studies, such as computed tomography scan (TC), in evaluating the tumor response to imatinib.…”

Section: Discussionmentioning

confidence: 99%

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Pathologic complete response with neoadjuvant imatinib for locally advanced pelvic GIST

et al. 2010

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There are few data that show pathologic complete response (pCR) to imatinib treatment in gastrointestinal stromal tumors (GISTs). We describe a case of a patient with pCR of a pelvic, locally advanced, high-risk GIST who was treated with neoadjuvant imatinib and ultimately underwent a conservative procedure. A 48-year-old male presented with a pelvic mass 10 cm in diameter. Biopsy revealed a gastrointestinal stromal tumor of rectal origin. Although it was considered initially resectable, an extensive procedure would have been necessary for complete resection. Treatment with imatinib was initiated, resulting in partial response. The patient remained on imatinib for over 15 months, maintaining stable disease. Radical prostatectomy with anal sphincter preservation was performed. Pathological report revealed no viable neoplastic cells. The use of imatinib was held for 6 months after the surgery. At a follow-up 15 months after surgery, the patient had no evidence of disease. Our report may help to guide future studies of neoadjuvant imatinib for large pelvic or rectum GISTs that are initially considered unresectable.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pathologic complete response with neoadjuvant imatinib for locally advanced pelvic GIST

et al. 2010

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“…10,11 A summary of the morphological findings of metastatic GIST after Gleevec treatment is shown in Table 1. [2][3][4][5][6][7][8] Gleevec-treated hepatic metastatic lesions show a variety of histological findings. Pyknotic nuclei in an eosinophilic myxoid background with a decrease in the density of the tumor cells, myxoid degeneration, and scarring have been documented.…”

Section: Discussionmentioning

confidence: 99%

“…2 The morphological findings such as cystic changes, hemorrhage, myxoid degeneration, or a decrease in the number of tumor cells have been demonstrated in metastatic GISTs after Gleevec treatment. [2][3][4][5][6][7][8] However, the morphological features attributed to Gleevec ingestion have not been well characterized. Metastatic GISTs after Gleevec treatment mimic reactive lesions, epithelioid or spindle cell tumors.…”

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confidence: 99%

Morphological Features of Metastatic Gastrointestinal Stromal Tumors after Gleevec Treatment - Two Cases Report -

et al. 2009

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We report two patients with metastatic gastrointestinal stromal tumors (GISTs) with a focus on the morphological features related to Gleevec treatment. In case 1, a 50-year-old woman presented with a 1.8 cm metastatic GIST in the liver after resection of a gastric GIST. Majority of the metastatic tumor showed fibrosis and hyalinization after 8 weeks of Gleevec treatment. CD117-positive cells were present in approximately 1% of the overall tumor. In case 2, a 2 cm and 14 cm metastatic liver masses were found in a 54-year-old man who had a rectal GIST. After 4 weeks of Gleevec treatment, metastatic tumors showed a decrease in size on CT scan. The metastatic tumors showed a decrease in number of tumor cells. The hemorrhage, cystic changes, necrosis, and fibrosis made up approximately 90% of the tumor. The morphological features related to Gleevec treatment are important for correct diagnosis and evaluation of tumor response and prognosis.

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“…-On one hand, there are no cures with only medical treatment for GISTs; long-term survival in advanced disease only results from surgical resection, and pathological study nearly always shows persistent viable cells and persistent c-kit signalling in resection specimens of apparent complete response cases after imatinib treatment [32, 93,94].…”

Section: Sunitinibmentioning

confidence: 99%

Gastrointestinal stromal tumours at present: an approach to burning questions

2010

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Because of their well known origin in gene mutations and a revolutionary therapy by means of molecular targets, gastrointestinal stromal tumours (GIST) constitute a plentiful and paradigmatic model of translational investigation, resulting in an avalanche of exponential growth data. In this article, we focus on what we consider to be hot spots in GIST at present. A wide spectrum of events is approached, extending from subtle pathogenic mechanisms at a molecular level (gene mutations and their implications for cell receptors with subsequent activation of signalling pathways) to more practical problems facing diagnosis (molecular markers, role of biopsy), prognosis (risk stratification systems) and different therapeutic aspects (laparoscopic surgery, role of surgery in advanced disease, response criteria, adjuvant and neoadjuvant therapy, treatment for progressing and recurrent disease, therapy directed on mutation analysis and new developments, among others). The review has been endorsed by level of evidence evaluation through a recognised pattern to assist in teaching, and a final summary of recommendations and a management algorithm are included.

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Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate

Cited by 8 publications

References 17 publications

Pathologic complete response with neoadjuvant imatinib for locally advanced pelvic GIST

Pathologic complete response with neoadjuvant imatinib for locally advanced pelvic GIST

Morphological Features of Metastatic Gastrointestinal Stromal Tumors after Gleevec Treatment - Two Cases Report -

Gastrointestinal stromal tumours at present: an approach to burning questions

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