手术治疗晚期胃肠间质瘤临床价值

Role of surgery in treatment of recurrent or metastatic gastrointestinal stromal tumor

胃肠间质瘤(GIST)是最常见的起源于消化道的软组织肿瘤。随着对其发病机制的认识,现对于复发和转移性GIST以靶向治疗为主要的治疗手段。然而其完全缓解率<5%,绝大多数病人由于继发性耐药而出现肿瘤进展,因而对于能否通过手术改善病人的预后是当前晚期GIST研究的热点。手术在晚期GIST的综合治疗中地位、要点、适应人群需引起临床医师的足够重视。

Gastrointestinal stromal tumor （GIST） is the most common soft tissue sarcomas of the gastrointestinal tract. With the understanding of the mechanisms of GIST carcinogenesis, tyrosine kinase inhibitors （TKIs） have greatly improved the prognosis of patients with recurrent or metastatic GIST, compared to traditional surgery. However, 5% of complete response and gradually appearance of secondary tumor resistance to TKIs still encourage surgeons to evaluate the effect of TKIs combined with surgery. Surgical cytoreduction in patients with recurrent or metastatic GISTs in era of target therapy is the hot spot. The surgery in highly selected patients who have good response to TKIs should be considered fully in the multidisciplinary treatment.