IMPACT DE L’IMATINIB EN NEOADJUVANT SUR LA PRESERVATION SPHINCTERIENNE, LA SURVIE SANS RECIDIVE ET LA SURVIE GLOBALE DANS LES GIST DU RECTUM

Abstract

Objective: To evaluate the impact of neoadjuvant imatinib in sphincter preservation and survival in GIST rectum. Patients and Methods: Retrospective study of four patients treated in the department of Surgery at Tenon Hospital for rectal GIST between 2005 and 2012. All tumors strongly expressed the C-Kit. Were included, patients treated with neoadjuvant imatinib. The impact of imatinib on the surgery was obtained by comparing the initial indication and the gesture made after imatinib. Results: The mean tumor size at diagnosis was 4.62 (3 and 6) and 2.45 cm (0 to 6) cm respectively at diagnosis and at the end of treatment with imatinib. The average duration of neoadjuvant imatinib was four months The indication for surgery was abdominoperineal resection in three cases because of reports of tumors with sphincter system. After treatment with imatinib, no amputation was performed. We performed a local resection of the tumor in two cases and a low anterior resection in one case. In the latter case, no action has been made. Urticaria was noted in one case requiring discontinuation of treatment after a month. In the latter case, the reduction in tumor size was not significant, but the rectal signs had disappeared. All patients are alive with disease-free survival (DFS) average of 22 months. Conclusion: The neoadjuvant imatinib allows sphincter preservation in rectal GIST. It decreases the risk of recurrence and improves overall survival (OS). GIST of the rectum are rare and reported primarily by clinical case studies, it is necessary to undertake large studies to better understand the impact of preoperative imatinib on surgery, SRH, and OS. Keywords: GIST - Rectum - Imatinib - sphincter preservation