Zalinski Stephane, Palavecino Martin, Abdalla Eddie K
Department of Surgical Oncology, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, TX 77030, USA.
Hematol Oncol Clin North Am. 2009 Feb;23(1):115-27, ix. doi: 10.1016/j.hoc.2008.11.001.
Liver resection is the preferred treatment for gastrointestinal stromal tumor liver metastases (GIST LMs) when complete resection can be achieved. Major and extended hepatic resections can be safely performed, and using modern techniques, an increasing proportion of patients with GIST LMs are candidates for potentially curative therapy. The combination of tyrosine kinase inhibitor therapy (eg, imatinib) with surgery seems to improve outcome, and although prospective data are lacking, a short neoadjuvant course (6 months) of imatinib therapy followed by resection may improve patient selection for surgery and outcome from treatment. Postoperative therapy with imatinib is generally advised, although the duration of such therapy is not yet clearly defined. These questions may formulate the basis for future prospective studies of imatinib with complete resection of GIST LMs.
当能够实现完全切除时，肝切除术是胃肠道间质瘤肝转移（GIST-LMs）的首选治疗方法。可以安全地进行大范围肝切除术，并且使用现代技术，越来越多的GIST-LMs患者有机会接受潜在的治愈性治疗。酪氨酸激酶抑制剂疗法（如伊马替尼）与手术相结合似乎可改善治疗效果，尽管缺乏前瞻性数据，但伊马替尼短程新辅助治疗（6个月）后再行手术切除，可能会改善手术患者的选择及治疗效果。一般建议术后使用伊马替尼治疗，尽管这种治疗的持续时间尚未明确界定。这些问题可能为未来伊马替尼与GIST-LMs完全切除联合应用的前瞻性研究奠定基础。
