Role of Surgery in Patients With Focally Progressive Gastrointestinal Stromal Tumors (GISTs) After Imatinib Treatment

Inclusion Criteria:

1. Patients whose pathology is clearly diagnosed as recurrent/metastatic GIST, have undergone standardized imatinib treatment, and the disease progresses during the treatment;
2. The lesions with progress are confined to one organ, and the number is ≤3; after evaluation by relevant professional surgeons or multidisciplinary team discussion, it is considered that the progressive lesions can be completely and safely removed without affecting the organ function;
3. Age: 18 years old ≤ age ≤ 75 years old;
4. No other malignant tumors occurred within five years;
5. Eastern Cooperative Oncology Group (ECOG) physical status score <2 points;
6. American Society of Anesthesiologists (ASA) score <3 points;
7. There are no restrictions on gender and race;
8. Patients with informed consent.

Exclusion Criteria:

1. The patient has other serious comorbidities and cannot tolerate surgery: such as severe cardiopulmonary disease, cardiac function in grade 2 or lower, pulmonary infection, moderate to severe chronic obstructive pulmonary disease (COPD), etc., combined with severe diabetes and/or kidney Insufficient function, combined with severe hepatitis and/or functional Child-pugh grade C or a grade B that is clearly difficult to correct, combined with severe malnutrition;
2. Patients with extensive disease progress;
3. Imatinib primary resistant patients;
4. Patients with other diseases requiring simultaneous surgical intervention, such as gallstones; inguinal hernia;
5. Disease-related complications such as bleeding, perforation, and obstruction;
6. Pregnant or lactating women;
7. The patient has a serious mental illness;
8. Patients with other malignant tumors within five years;
9. The patient has participated in or is participating in other clinical studies or is using other tyrosinekinase inhibitors.