AIM: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor 
of the gastrointestinal tract. Surgery remains the elective treatment. We 
retrospectively compared two group of patients, who underwent surgery for GIST 
before and after Imatinib advent in order to analyze the recurrence and survival 
rate.
METHODS: Two patient groups who underwent surgery for GIST, from January 1997 to 
December 2002 (Pre-Imatinib group) and from January 2003 to December 2008 
(Post-Imatinib group) were compared. Patients were evaluated on the base of 
gender, age, clinical manifestations, primary location and metastasis 
positivity, tumor size, mitotic index, immunoreactivity for CD117 and the 
outcome, including date of death.
RESULTS: In the Pre-IM group only one patient died for prostate cancer, 12 
months after operation, the other died because of GIST with a 24.6 months of 
median survival rate (range 15-51). In the remaining 12 patients the median 
follow up period was 55 months (range 6-152 months). In the Post-IM group the 
mean follow up was 50.7 months (range 26-74) and they are still being assessed 
for oncological as well as surgical treatment.
CONCLUSION: Early diagnosis and radical resection remain the standard of cure 
for GISTs. To date, the use of Imatinib lead to its utilization as adjuvant and 
neo-adjuvant therapy in adults. Our experience suggests that there is a 
correlation between the mutational status of KIT and clinical outcome. These 
aspects should be explored for targeted therapy that can effectively combine 
biological therapy to surgery.