For patients who received neoadjuvant Imatinib for initially unresectable GIST tumours, do you routinely prescribe adjuvant therapy or rely on preoperative staging and preoperative mitotic index?

I agree with Dr Groisberg. Another way to look at it is that if the patient would have qualified by preoperative risk factors, I wouldn’t “downgrade” that by the improved risk tumor that comes out. Sometimes you can’t be sure ahead of time- for example I just saw a patient with a 3 cm duodenal tumor...