What are the NCCN treatment guidelines for localized resectable GISTs?

Updated: Sep 02, 2018
  • Author: Steven C Katz, MD, FACS; Chief Editor: Edwin Choy, MD, PhD  more...
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NCCN treatment recommendations for localized resectable disease include the following [6] :

  • Surgical resection is the primary treatment.
  • For tumors < 2 cm with no high-risk features, consider periodic endoscopic surveillance.
  • Preoperative treatment with imatinib may prevent accurate assessment of recurrence risk; consider preoperative imatinib only for marginally resectable or initially unresectable tumors, where surgical morbidity could be reduced by downstaging the tumor preoperatively.
  • Testing the tumor to ensure it has a mutation that is likely to respond to imatinib (especially  KIT exon 11) is recommended prior to starting preoperative imatinib.
  • Consider postoperative imatinib for at least 36 months for high-risk tumors.

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