Treatment Planning:
Resectable Gastrointestinal Stromal Tumors
Resectable gastrointestinal stromal tumors (GISTs) can be completely or almost completely removed by surgery. Treatment may include the following: If there are cancer cells remaining at the edges of the area where the tumor was removed, watchful waiting or targeted therapy with imatinib mesylate may follow. A clinical trial of targeted therapy with imatinib mesylate following surgery, to decrease the chance the tumor will recur (come back).
Unresectable Gastrointestinal Stromal Tumors
Unresectable GISTs cannot be completely removed by surgery because they are too large or in a place where there would be too much damage to nearby organs if the tumor is removed. Treatment is usually a clinical trial of targeted therapy with imatinib mesylate to shrink the tumor, followed by surgery to remove as much of the tumor as possible.
Metastatic and Recurrent Gastrointestinal Stromal Tumors
Treatment of GISTs that are metastatic (spread to other parts of the body) or recurrent (came back after treatment) may include the following:
- Targeted therapy with imatinib mesylate.
- Targeted therapy with sunitinib, if the tumor begins to grow during imatinib mesylate therapy or if the side effects are too bad.
- Surgery to remove tumors that have been treated with targeted therapy and are shrinking, stable(not changing), or that have slightly increased in size. Targeted therapy may continue after surgery.
- Surgery to remove tumors when there are serious complications, such as bleeding, a hole in thegastrointestinal (GI) tract, a blocked GI tract, or infection.