Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment

In the multidisciplinary management of gastrointestinal stromal tumours (GISTs), there is a need to coordinate the efforts of pathology, radiology, surgery and oncology. Surgery is the mainstay for resectable nonmetastatic GISTs, but virtually all GISTs are associated with a risk of metastasis. Imat...

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Main Authors: Martin E Blackstein, Jean-Yves Blay, Christopher Corless, David K Driman, Robert Riddell, Denis Soulières, Carol J Swallow, Shailendra Verma, on behalf of the Canadian Advisory Committee on GIST
Format: Article
Language:English
Published: Wiley 2006-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2006/434761
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author Martin E Blackstein
Jean-Yves Blay
Christopher Corless
David K Driman
Robert Riddell
Denis Soulières
Carol J Swallow
Shailendra Verma
on behalf of the Canadian Advisory Committee on GIST
author_facet Martin E Blackstein
Jean-Yves Blay
Christopher Corless
David K Driman
Robert Riddell
Denis Soulières
Carol J Swallow
Shailendra Verma
on behalf of the Canadian Advisory Committee on GIST
author_sort Martin E Blackstein
collection DOAJ
description In the multidisciplinary management of gastrointestinal stromal tumours (GISTs), there is a need to coordinate the efforts of pathology, radiology, surgery and oncology. Surgery is the mainstay for resectable nonmetastatic GISTs, but virtually all GISTs are associated with a risk of metastasis. Imatinib 400 mg/day with or without surgery is the recommended first-line treatment for recurrent or metastatic GIST; a higher dose may be considered in patients who progress, develop secondary resistance or present with specific genotypic characteristics. Adjuvant or neoadjuvant imatinib is not advised for resectable non-metastatic GISTs. Neoadjuvant imatinib may be considered when surgery would result in significant morbidity or loss of organ function. Follow-up computed tomography imaging is recommended every three to six months for at least five years. Patients with metastatic disease should be continued on imatinib due to the high risk of recurrence on discontinuation of therapy. Treatment should be continued until there is progression or intolerable adverse effects. If dose escalation with imatinib fails, a clinical trial with novel agents alone or in combination may be considered. The present recommendations were developed at a surgical subcommittee meeting and a subsequent full Advisory Committee meeting held in Toronto, Ontario, in April 2005, under the sponsorship of Novartis Pharmaceuticals Canada Inc.
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spelling doaj-art-f0b1d2e69b8a48e1864d7e65c25a2ccb2025-08-20T03:21:27ZengWileyCanadian Journal of Gastroenterology0835-79002006-01-0120315716310.1155/2006/434761Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and TreatmentMartin E Blackstein0Jean-Yves Blay1Christopher Corless2David K Driman3Robert Riddell4Denis Soulières5Carol J Swallow6Shailendra Verma7on behalf of the Canadian Advisory Committee on GISTMount Sinai Hospital, Toronto, Ontario, CanadaUniversité Claude Bernard Lyon, Villeurbanne, FranceOregon Health & Science University, Portland, Oregon, USAUniversity of Western Ontario, London, Ontario, CanadaMount Sinai Hospital, Toronto, Ontario, CanadaCentre Hospitalier de l’Université de Montréal, Montreal, Quebec, CanadaMount Sinai Hospital, Toronto, Ontario, CanadaOttawa Hospital Regional Cancer Centre, Ottawa, Ontario, CanadaIn the multidisciplinary management of gastrointestinal stromal tumours (GISTs), there is a need to coordinate the efforts of pathology, radiology, surgery and oncology. Surgery is the mainstay for resectable nonmetastatic GISTs, but virtually all GISTs are associated with a risk of metastasis. Imatinib 400 mg/day with or without surgery is the recommended first-line treatment for recurrent or metastatic GIST; a higher dose may be considered in patients who progress, develop secondary resistance or present with specific genotypic characteristics. Adjuvant or neoadjuvant imatinib is not advised for resectable non-metastatic GISTs. Neoadjuvant imatinib may be considered when surgery would result in significant morbidity or loss of organ function. Follow-up computed tomography imaging is recommended every three to six months for at least five years. Patients with metastatic disease should be continued on imatinib due to the high risk of recurrence on discontinuation of therapy. Treatment should be continued until there is progression or intolerable adverse effects. If dose escalation with imatinib fails, a clinical trial with novel agents alone or in combination may be considered. The present recommendations were developed at a surgical subcommittee meeting and a subsequent full Advisory Committee meeting held in Toronto, Ontario, in April 2005, under the sponsorship of Novartis Pharmaceuticals Canada Inc.http://dx.doi.org/10.1155/2006/434761
spellingShingle Martin E Blackstein
Jean-Yves Blay
Christopher Corless
David K Driman
Robert Riddell
Denis Soulières
Carol J Swallow
Shailendra Verma
on behalf of the Canadian Advisory Committee on GIST
Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment
Canadian Journal of Gastroenterology
title Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment
title_full Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment
title_fullStr Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment
title_full_unstemmed Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment
title_short Gastrointestinal Stromal Tumours: Consensus Statement on Diagnosis and Treatment
title_sort gastrointestinal stromal tumours consensus statement on diagnosis and treatment
url http://dx.doi.org/10.1155/2006/434761
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