Treatment of advanced gastrointestinal stromal tumors acquired resistance to imatinib        WANG Hong-shan*, WANG Cui-zhong, HOU Ying-yong, et al. *Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Corresponding author: SHEN Kun-tang, E-mail: kuntang_shen@yahoo.com
Abstract    Objective    To discuss and explore the treatment strategy for recurrent and metastatic advanced gastrointestinal stromal tumors (GIST) acquired resistance to imatinib. Methods    The clinical data of 8 cases of recurrent and metastatic advanced GIST acquired resistance to imatinib admitted between 2000 and 2009 at Zhongshan Hospital of Fudan University were analyzed retrospectively. Results    All cases were performed complete resection of primary tumors, followed by oral administration of imatinib. All cases got acquired resistance to imatinib before or after recurrence and/or metastasis. A comprehensive treatment of surgical resection combined with molecularly targeted therapy was employed with considerably effectiveness in all cases. One case died of recurrence after 96 months of survival time. Other 7 cases survived for 98.6 months of the mean existing survival time（65-145 months）. Conclusion For recurrent and metastatic advanced GIST acquired resistance to imatinib, a multidisciplinary approach, mainly characterized by surgical resection combined with molecularly targeted therapy based on gene features, is an effective treatment strategy, which can offer a better prognosis.