METHODS and RESULTS
Following a multidisciplinary diagnosis and treatment, it was determined that the current effectiveness of sunitinib in treating GIST metastasis was unsatisfactory. Therefore, a debulking surgery followed by targeted therapy was recommended to maximize the patient’s lifespan. The postoperative pathology reports indicated a high-risk GIST (Figure 3B), with immunohistochemical analysis showing CD117 (++++), CD34 (+), SMA (++++), Dog1 (++++), Desmin (-), S-100 (-), ki-67 (25%+), and SDHB (++++). Genetic testing revealed c-KIT exon 11 mutation sites. The patient received postoperative treatment with a conventional dose of the third-generation TKI, regorafenib. Regular follow-up examinations conducted over a span of nine months until December 2022 revealed no significant progression of metastases.