Role of Surgery in Patients With Focally Progressive Gastrointestinal Stromal Tumors (GISTs) After Imatinib Treatment

Inclusion Criteria: 1. Patients whose pathology is clearly diagnosed as recurrent/metastatic GIST, have undergone standardized imatinib treatment, and the disease progresses during the treatment; 2. The lesions with progress are confined to one organ, and the number is ≤3; after evaluation by relevant professional surgeons or multidisciplinary team discussion, it is considered that the progressive lesions can be completely and safely removed without affecting the organ function; 3. Age: 18 years old ≤ age ≤ 75 years old; 4. No other malignant tumors occurred within five years; 5. Eastern Cooperative Oncology Group (ECOG) physical status score \<2 points; 6. American Society of Anesthesiologists (ASA) score \<3 points; 7. There are no restrictions on gender and race; 8. Patients with informed consent. Exclusion Criteria: 1. The patient has other serious comorbidities and cannot tolerate surgery: such as severe cardiopulmonary disease, cardiac function in grade 2 or lower, pulmonary infection, moderate to severe chronic obstructive pulmonary disease (COPD), etc., combined with severe diabetes and/or kidney Insufficient function, combined with severe hepatitis and/or functional Child-pugh grade C or a grade B that is clearly difficult to correct, combined with severe malnutrition; 2. Patients with extensive disease progress; 3. Imatinib primary resistant patients; 4. Patients with other diseases requiring simultaneous surgical intervention, such as gallstones; inguinal hernia; 5. Disease-related complications such as bleeding, perforation, and obstruction; 6. Pregnant or lactating women; 7. The patient has a serious mental illness; 8. Patients with other malignant tumors within five years; 9. The patient has participated in or is participating in other clinical studies or is using other tyrosinekinase inhibitors.