Abstract

Although the term neoadjuvant correctly applies to atherapy provided in the preoperative setting in patients withprimary disease, it is highly misleading when applied to atherapy provided before surgery in patients with metastaticdisease. In the former setting, in patients with localizeddisease, the primary therapy is surgery; imatinib plays anadjuvant/neoadjuvant role. In metastatic disease, imatinibis the primary therapy and should not be discontinued;surgery may play an adjuvant role, although this is not yetproven. Indeed, these two scenarios are quite different.They were separately analyzed and should be separatelydiscussed and put in perspective.PRIMARY DISEASESurgery is the only potentially curative therapy forpatients with localized primary GIST. All patients withtumors [2 cm in size should undergo surgical resection.

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