Long-term follow-up of imatinib mesylate treatment for patients with recurrent gastrointestinal stromal tumor: liver metastases was not a predictor for poor outcome

Background About 80% patients with GIST would experience tumor recurrence or metastases after a prior radical resection. The most common metastatic site is liver. Imatinib mesylate was proved to be effective for advanced GIST. Current study was designed to observe the influence of liver metastases to the outcome of imatinib treatment for recurrent GIST from prior surgery. Methods 42 patients had recurrent GIST from prior radical resection were enrolled. Depend on the existence of liver involvement, 2 different patterns of recurrent GIST were divided. Patients were administered Glivec at an initial dose of 400 mg per day. Their medical information was prospectively recorded. A long-term follow up over 3 years had been performed. Tumor response, time to progression and survival were evaluated. Results Imatinib treatment was safe and well tolerated. At a median follow up time of 39.5 months, the 3-year survival rate was 66.7%. Median TTP and OS were 37 months (95% CI: 28.2~45.8 months) and 48 months (95% CI: 37.0~58.9 months), respectively. Differences in response or toxicities between the 2 groups were of non statistical significance. Similar TTP (P=0.974) and OS (P=0.919) were observed in patients had liver metastases and in patients had not. Patients with only liver metastases achieved the best 3-year survival rate of 80%. Conclusion Imatinib mesylate treatment could prolong survival of patients who had recurrent GIST from a radical surgery even liver metastases existed. Liver metastases might not be regarded as a poor prognostic factor for recurrent GIST if treated with imatinib.