Surgical treatment of XXXX in the @entity2213 ( @entity2213 ) era.

@entity1 @entity5 @entity3 @entity2467 @entity361 @entity669 @entity2213 @entity674
BACKGROUND: @entity674 ( @entity674 ) are rare @entity361 that are characterized by constitutive overexpression of the @entity669 kinase receptor @entity2467 ( @entity2467 ). @entity2213 is a selective inhibitor of @entity669 kinase-mediated activity. This study reports a single-institution experience of surgical resection and the use of @entity2213 in the treatment of @entity674 . METHODS: A retrospective review from 1995 to 2002 identified 57 @entity1 (M:F, 29:28; median age, 61 years) with @entity674 who were treated at the University of Chicago. Twenty-eight @entity1 underwent exploratory surgery with curative intent; 29 @entity1 were referred for treatment of @entity3 after surgery at outside institutions. Twenty-nine @entity1 were treated with oral @entity2213 for either @entity3 (n=26 @entity1 ) or in the adjuvant setting after complete resection (n=3 @entity1 ). RESULTS: Resections were performed in 53 @entity1 , and @entity3 was identified in 17 @entity1 at the time of exploratory surgery. Immunohistochemical staining for @entity2467 was positive in 96% of @entity1 . A size larger than 5 cm, a mitotic rate larger than 1/10 high-power field, and @entity5 necrosis predicted recurrence in @entity1 after resection. The median follow-up period was 18 months (range, 4-81 months). Twenty-three @entity1 (40%) are alive without disease; 22 @entity1 (39%) are alive with disease; 7 @entity1 died, and 5 @entity1 are lost to follow-up. Among the 26 @entity1 with @entity3 who were treated with @entity2213 , 5 deaths have occurred, and disease stabilization or @entity5 regression was observed initially in 22 @entity1 , with a median duration of response of 19 months. CONCLUSIONS: Complete surgical extirpation remains the only curative treatment of @entity674 . @entity2213 -targeted therapy of @entity3 yields encouraging clinical responses. The true efficacy of @entity2213 in this setting, as induction therapy or as an adjuvant treatment in @entity1 with @entity674 , is unknown pending the completion of ongoing prospective trials.
