Kaneko Manabu, Emoto Shigenobu, Murono Koji, Sonoda Hirofumi, Hiyoshi Masaya, Sasaki Kazuhito, Shuno Yasutaka, Nishikawa Takeshi, Tanaka Toshiaki, Hata Keisuke, Kawai Kazushige, Nozawa Hiroaki
Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Surg Today. 2019 Jun;49(6):460-466. doi: 10.1007/s00595-018-1737-5. Epub 2018 Nov 15.
Rectal gastrointestinal stromal tumor (GIST) is a rare entity. Thus, its clinical features have not been well documented, and optimal treatment strategies have not been established. Surgery for rectal GISTs may be difficult because they are often large in size. In addition, rectal GISTs were found to be associated with high rates of local recurrence, regardless of the surgical procedure, before imatinib was introduced in the early 2000s. Since the introduction of imatinib therapy, accumulating evidence suggests that neoadjuvant imatinib therapy may improve the outcomes of rectal GIST treatment. Neoadjuvant imatinib therapy for rectal GISTs offers a number of potential benefits, including tumor downsizing, reduction in mitotic activity, reduced morbidity, and a reduced risk of recurrence. Less radical procedures may allow for the preservation of the anal sphincter and avoidance of a permanent colostomy. This review summarizes the current status and future perspectives of neoadjuvant imatinib therapy for the treatment of rectal GISTs.
直肠胃肠道间质瘤（GIST）是一种罕见的疾病。因此，其临床特征尚未得到充分记录，最佳治疗策略也尚未确立。直肠GIST的手术可能具有挑战性，因为它们通常体积较大。此外，在21世纪初伊马替尼引入之前，无论采用何种手术方式，直肠GIST都被发现局部复发率较高。自伊马替尼治疗引入以来，越来越多的证据表明新辅助伊马替尼治疗可能改善直肠GIST的治疗效果。直肠GIST的新辅助伊马替尼治疗具有许多潜在益处，包括肿瘤缩小、有丝分裂活性降低、发病率降低以及复发风险降低。采用创伤较小的手术方式可能有助于保留肛门括约肌并避免永久性结肠造口术。本综述总结了新辅助伊马替尼治疗直肠GIST的现状和未来展望。
