To Compare the Efficacy of Surgery Followed by Sunitinib With Surgery Followed by Imatinib in GIST Patients With Progression on Imatinib.

A Retrospective Cohort Study

To compare the efficacy of surgery followed by sunitinib with surgery followed by imatinib in GIST patients with progression on imatinib;To investigate the optimal therapy after surgery in GIST patients with focal or multifocal progression in imatinib

Primary Endpoint: To evaluate the progression free survival of the patients with progression receiving surgery followed by sunitinib therapy comparing with surgery followed by imatinib Secondary Endpoint：To evaluate the overall survival of the patients with progression receiving surgery followed by sunitinib therapy comparing with surgery followed by imatinib the relationship of c-kit secondary mutation and progression free survival of surgery followed by TKI therapy the safety and tolerability of the two therapy.

Statistics:All the statistical analysis is performed using SPSS version 20.0 (IBM corporation, United States). Pearson's chi-squared test was used to compare categorical variables. PFS and OS analyses were estimated with Kaplan-Meier method and log-rank test and multivariable analyses were performed to assess survival difference. A two sided p-value of <0.05 was considered statistically significant.

Inclusion Criteria:

1. .Histopathological diagnosis of metastatic GIST.
2. . After the treatment of imatinib, imatinib 400mg/day after treatment, the tumor generalized.
3. . Patients with generalized progress were satisfied with tumor reduction after imatinib resistance for various reasons.
4. at least 1 month after surgery for imatinib treatment or sunitinib treatment.
5. at least one imaging assessment was received after surgery.
6. . Complete clinical data and follow-up data.

Exclusion Criteria:

1. . Before operation, he was treated with sunitinib
2. . Patients receiving tumor reduction were not satisfied with the standard of the reduction of tumor.
3. . The treatment of imatinib or sunitinib after surgery was less than 1 month.
4. . Incomplete clinical data or follow-up data.