The two patients received oral imatinib therapy after cytoreductive surgery, and revealed no residual disease for a long-term period of time. Although more studies are needed to confirm whether cytoreductive surgery is additive to imatinib treatment, our results were very encouraging in this regard. Therefore, in patients Nilotinib Leukemia with far advanced or recurring GISTs, improved survival could be expected by imatinib oral therapy after removal of tumors as much as possible. In far advanced or severely metastasized patients, neoadjuvant therapy commonly enables curative surgical resection. Indeed, neoadjuvant therapy with imatinib for treatment of malignant GISTs is able to increase the rate of complete cytoreductive surgery.

There are several reports of neoadjuvant imatinib chemotherapy therapy used to treat primary unresectable GISTs, allowing them to be resected completely. However, resistance is commonly observed after neoadjuvant imatinib therapy, and surgical intervention should always be considered in neoadjuvant therapy group, since the duration of neoadjuvant chemotherapy and an optimal time for surgery are decisive factors.16 Even after complete resection of primary tumor, more than half of patients experience recurrence of tumors. And the first site of recurrence is usually limited in the abdomen, even though recurrent GISTs have a multifocal nature.17 However, complete resection can be achieved only in less than half of patients. Thus, patients should be followed up regularly from early period after resection of the primary tumor, because an early detection of metastasis could possibly increase complete cytoreduction of the recurrent tumor burden.

Furthermore, this complete cytoreduction followed by imatinib therapy might be able to improve the survival of patients with recurrent GISTs.
AIM: To evaluate the feasibility and efficacy of percutaneous radiofrequency ablation (RFA) of the feeding artery of hepatocellular carcinoma (HCC) in reducing the blood-flow-induced heat-sink effect of RFA. METHODS: A total of 154 HCC patients with 177 pathologically confirmed hypervascular lesions participated in the study and were randomly assigned into two groups. Seventy-one patients with 75 HCCs (average tumor size, 4.3 �� 1.

1 cm) were included in group A, in which the feeding artery of HCC was identified by color Doppler flow imaging, and were ablated with multiple small overlapping RFA foci [percutaneous ablation of feeding artery (PAA)] before routine RFA treatment of the tumor. Eighty-three patients with Dacomitinib 102 HCC (average tumor size, 4.1 �� 1.0 cm) were included in group B, in which the tumors were treated routinely with RFA. Contrast-enhanced computed tomography was used as post-RFA imaging, when patients were followed-up for 1, 3 and 6 mo. RESULTS: In group A, feeding arteries were blocked in 66 (88%) HCC lesions, and the size of arteries decreased in nine (12%).