Pancreas preserving surgery for duodenal gastrointestinal stromal tumor removal.

BACKGROUND: We reported our experience with high-risk, non-metastatic second portion duodenal gastrointestinal stromal tumor (GIST)s in patients who underwent 1-month neoadjuvant cycles with imatinib therapy followed by pancreas-preserving surgery and 12-month of adjuvant chemotherapic regimen including imatinib. This study was conducted to evaluate the short and long-term results.

METHODS: The study was conducted between January 2010 and May 2015. Medical charts and operative logbooks of patients were retrospectively reviewed.

RESULTS: Nine patients form the basis of the current analysis. All patients underwent curative resection with pancreas preservation, and all specimens had histologically negative margins. The median follow-up was 35 months. Eight patients were alive, 1 patient died for myocardial infarction at a mean follow-up of 10 months, 1 patient had a recurrence at a mean follow-up of 32 months and no patients developed distant metastases.

CONCLUSIONS: We are confident to suggest the use of neoadjuvant and adjuvant Imatinib therapy to those patients affected with D2, high-risk, duodenal GISTs to allow a limited resection.