Treatment of Localized Resectable Gastrointestinal Stromal Tumor
When a gastrointestinal stromal tumor (GIST) is localized and amenable to surgical removal, the management approach is well defined. The specific scenario — tumor confined to the primary site and technically resectable — calls for a structured, evidence-based plan targeting complete tumor eradication.
Clinical Scenario
This protocol applies to patients with a localized, resectable gastrointestinal stromal tumor. Complete surgical resection is the standard treatment for localized GIST, aiming for clear margins and intact tumor removal.
Treatment Approach
The cornerstone of management is complete surgical resection, performed with careful technique to preserve tumor integrity. For patients identified as high risk, adjuvant systemic therapy targeting specific molecular alterations may be indicated after surgery — see the full protocol for details on duration, selection criteria, and sequencing.
References
DOI: 10.1177/17588359231192388
- Complete surgical resection is the standard treatment for localized GIST.
- The goal is an R0 surgery with complete removal of the tumor, including an intact pseudocapsule.
- Recommended macroscopic resection margin is 1 cm.
- The standard treatment of localized GISTs is a complete surgical resection (III,A).
- Adjuvant treatment with imatinib 400 mg daily is indicated in GIST patients at high risk of relapse-bearing imatinib-sensitive mutations in KIT or PDGFRA (I,A).
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