Long-term survival of a case with multiple liver metastases from duodenal gastrointestinal stromal tumor drastically reduced by the treatment with imatinib and hepatectomy

工具包受体酷氨酸激酶的组成的激活是在胃肠的基质肿瘤(大意) 的致病的一个关键因素。但是几乎没有 imatinib mesylate (IM ) 和外科疗法的联合是否能与 unresectable 在情况中延长幸存的很少信息多重肝转移。我们报导酷氨酸激酶禁止者 IM 和外科疗法对待的大意的手术后的复发的一个案例。对处理的起始的完全的反应(CR ) 为 18 瞬间继续，但是单个肝转移在 IM 处理期间在左肝的脑叶显示出生长。在再发性瘤的部分切除术以后，手术后的路线是平静的，没有复发，病人为 24 瞬间幸存。当前， imatinib 是为 non-resectable 大意的首要的治疗，但是单个代理人治疗经常导致肿瘤抵抗。就算到 imatinib 的忍耐发生， imatinib 和外科疗法的联合能在这里报导了的一些情况中延长幸存。然而，周期性的大意的很多案例上的进一步的研究是必要的评估治疗与外科相结合的 IM 的有效性。

Constitutive activation of KIT receptor tyrosine kinase is a critical factor in the pathogenesis of gastrointestinal stromal tumors （GISTs）. But there is little information on whether combination of imatinib mesylate （IM） and surgical treatment can prolong survival in the cases with unresectable multiple liver metastases. We report a case of postoperative recurrence of GIST treated by the tyrosine kinase inhibitor IN and surgical treatment. The initial complete response （CR） to treatment continued for 18 mo, but single liver metastasis showed regrowth in the left hepatic lobe during IN treatment. After partial resection of the recurrent tumor, postoperative course was uneventful and the patient has survived without recurrence for 24 too. Currently, imatinib is the first- line therapy for non-resectable GISTs, but a single agent therapy often leads to tumor resistance. Even if tolerance to imatinib occurs, a combination of imatinib and surgical treatment can prolong survival in some cases as reported here. However, further studies on a large number of cases of recurrent GIST are necessary to evaluate the effectiveness of IN treatment combined with surgery.