Perioperative Imatinib Treatment Continuation Patterns and Long-Term Outcomes in Locally Advanced Gastrointestinal Stromal Tumors After Neoadjuvant Therapy: An Exploratory Two-Center Retrospective Study.

Authors

Jin-Hu Chen, Zhi-Ming Cai, Zhen-Rong Yang, Tao Lin, Shi-Chai Hong, Xin-Cheng Su, Yue-Ming Lin, Zheng-Xing Lin, Zai-Sheng Ye, Yong-Jian Zhou

Published in

Cancer research and treatment. Aug 10, 2026. Epub Aug 10, 2026.

Abstract

To describe perioperative imatinib continuation patterns and explore associations with long-term outcomes in patients with locally advanced gastrointestinal stromal tumors (GIST) undergoing curative-intent surgery after neoadjuvant therapy.
We retrospectively screened 395 patients receiving preoperative imatinib at two centers from 2012 to 2024. The analytic cohort comprised 171 patients with primary locally advanced GIST who underwent curative-intent surgery after neoadjuvant imatinib. Total perioperative exposure combined neoadjuvant and adjuvant treatment durations. Kaplan-Meier, Cox regression, and a 36-month landmark analysis were performed. Recurrence patterns and post-recurrence management were reviewed in 39 recurrent cases.
Median follow-up was 46 months; 39 patients (22.8%) recurred and 20 (11.7%) died. Five-year overall survival was 76.1%, 91.7%, and 96.7% for total exposure ≤36, >36 to ≤48, and >48 months, respectively, whereas recurrence-free survival did not differ significantly. In the landmark cohort (n=97), exposure >36 months was not significantly associated with post-landmark recurrence-free survival (HR, 0.881; 95% CI, 0.319 to 2.431; P=0.807) or overall survival (HR, 0.238; 95% CI, 0.043 to 1.303; P=0.098). Liver metastasis (53.8%) and peritoneal/abdominal dissemination (48.7%) were the most frequently documented first recurrence sites; 38.5% had multisite recurrence and 15.4% received local treatment.
Longer perioperative imatinib exposure showed favorable survival patterns in fixed-exposure analyses, but the association was attenuated in landmark analysis. These surgery-conditioned findings are exploratory and do not establish an optimal treatment duration.

PMID:
42594969
Bibliographic data and abstract were imported from PubMed on 14 Aug 2026.

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