Neoadjuvant Imatinib Mesylate Associated To Surgery For The Treatment Of Advanced GIST Patients: A Meta-Analysis

ObjectiveIn patients with primary gastrointestinal stromal tumors,surgery remains the standard treatment, while the appearance of TKI drug,imatinib mesylate has been standardized in advanced gastrointestinal stromal tumors.A combination of imatinib mesylate and surgery may be effective in advanced GIST. In this review,the authors analyzed the role of imatinib mesylate associated to surgery in advanced GIST.MethodsWe searched the electronic databases including PubMed,ISC Proceedings,ScienceDirect,OVID,EMBASE,Cochrane Central Register of Controlled Trials.The cochrane collaboration's RevMan 5.0.18 software was used for statistical analysis.ResultSeven articles were included.The methodological quality of the included studies was good.The baseline data of each trial were comparable.The results of meta-analyses indicated that a minor incidence of recurrent or metastatic gastrointestinal stromal tumors and a greater incidence of locally unresectable gastrointestinal stromal tumors in the responsive disease group (P=0.001).In this patient group,more complete resections were observed (P=0.00001),and a more significant 12 and 24-month disease-free survival after imatinib mesylate treatment and complete resection(P=0.06 and P=0.003) and also a better 24-month overall survival (P=0.004).ConclusionsThere is a certain effective in the role of imatinib mesylate combine surgery in advanced GIST,but it need some large clincal trials to support.