Surgical Therapy for GIST Overview Gastric

Surgical Therapy for GIST

Overview

Gastric GIST

Gastric GIST is not adenocarcinoma

Exophytic GIST: Only limited gastric resection necessary

Lesser curve GIST often requires an anatomic stomach resection

Anatomic stomach resection requires reconstruction

Locally advanced gastric GIST may involve multiple organs

Small Bowel GIST ( Non duodenal)

Limited small bowel GIST

Small bowel GIST may involve other organs

Duodenal GIST: Surgical Options

Pylorus Preserving Whipple

Reconstruction after Whipple

Segmental resection of duodenum

Laparoscopic Resection of GIST

Laparoscopy

The locally advanced GIST

Surgical treatment of the large GIST

En Bloc Resection

Preoperative Imatinib in Locally Advanced GIST

RTOG 0132

RTOG 0132: Surgical Complications

RTOG 0132 Disease Control

RTOG 0132 Conclusions

Imatinib and locally advanced GIST

Surgical Therapy for Metastatic GIST

Management of Patients With Advanced GIST

Aggressive surgery for metastatic disease

Outcome after resection

Adding Surgery to TKI Therapy

Surgery to “Reset” the Clock

Strategies for the patient with metastatic disease

Large Right Liver Lesion

After Liver Resection

Clinical Course

Recurrent Disease

New Agent Becomes Available: BLU-285

Starts Study Drug 15 months after Surgery

Surgical Treatment opens door to future treatments

The future is coming quickly

Its all about the Team

Strategies for the patient with metastatic disease

Surgical Therapy for GIST: Summary

Summary

Thanks Questions