临床外科杂志 ›› 2025, Vol. 33 ›› Issue (6): 661-664.doi: 10.3969/j.issn.1005-6483.20250595

• 综述与讲座 • 上一篇    下一篇

晚期胃肠间质瘤手术治疗的价值和相关进展

颜淼 卢逸 张信华   

  1. 510000 广州,中山大学附属第一医院胃肠外科
  • 收稿日期:2025-05-09 出版日期:2025-06-20 发布日期:2025-06-20
  • 通讯作者: 张信华,Email:zhangxinhua@mail.sysu.edu.cn

The value and updates of surgical treatment for advanced gastrointestinal stromal tumors

YAN Miao,LU Yi,ZHANG Xinhua   

  1. Department of Gastrointestinal Surgery,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000,China
  • Received:2025-05-09 Online:2025-06-20 Published:2025-06-20

摘要: 伊马替尼是晚期胃肠间质瘤(GIST)的标准一线治疗,但一半的病人在18~24个月内出现耐药。近年来,越来越多的回顾性研究表明,手术可以作为酪氨酸激酶抑制剂的辅助治疗,延后发生耐药的时间,改善病人预后。对靶向治疗治疗获益或局部进展、预期可以R0/R1切除的晚期GIST病人可能从手术中获益。由于缺乏高质量的研究证据,手术决策、病人选择和靶向治疗的衔接等问题仍存争议,晚期GIST的手术治疗应该在多学科诊疗的框架下个体化施行。

关键词: 晚期胃肠间质瘤; 手术治疗; 生存预后; 酪氨酸激酶抑制剂

Abstract: Imatinib is the standard first-line treatment for advanced gastrointestinal stromal tumors(GISTs),but half of patients develop drug resistance within 18 to 24 months.In recent years,more and more retrospective studies have shown that surgery can be used as an adjunct therapy to tyrosine kinase inhibitors(TKIs),delay the onset of drug resistance,and improve patient prognosis.Patients with advanced GISTs who have benefited from targeted therapy or have limited progression and those who are expected to achieve R0/R1 resections may benefit from surgery.Due to the lack of high-quality research evidence,surgical decision-making,patient selection,and the sequence of targeted therapy are still under controversy.The surgical treatment of advanced GISTs should be carried out in a case-by-case manner under the framework of multidisciplinary team guidance.

Key words: advanced gastrointestinal stromal tumor;surgery;survival prognosis;tyrosine kinase inhibitors

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