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Annicchiarico A, Montali F, Baldinu M, Casali L, Virgilio E, Costi R. Leiomyosarcoma of the rectum: A systematic review of recent literature. J Surg Oncol 2024; 129:365-380. [PMID: 37814590 DOI: 10.1002/jso.27481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/19/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
Leiomyosarcomas (LMSs) are rare tumors originating from the muscular layer. We performed a literature review of cases of confirmed rectal leiomyosarcomas (rLMSs) to clarify the history of such an infrequent tumor arising at such an uncommon location. In this research local recurrence was related to poorly differentiated rLMS and no other association between recurrence and any criteria was found. Concerning overall survival (OS), rLMS patients developing recurrence presented shorter longevity compared with the group without.
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Affiliation(s)
- Alfredo Annicchiarico
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Filippo Montali
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Manuel Baldinu
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Lorenzo Casali
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Edoardo Virgilio
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
| | - Renato Costi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of General Surgery, Vaio Hospital, Fidenza, Italy
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Massaras D, Kontis E, Stamatis K, Zampeli E, Myoteri D, Primetis E, Pantiora E, Fragulidis G. Primary leiomyosarcoma of the colon with synchronous liver metastasis. Rare Tumors 2022; 14:20363613221080549. [PMID: 35360880 PMCID: PMC8961372 DOI: 10.1177/20363613221080549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/27/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Dimitrios Massaras
- 2ndDepartment of Surgery, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - Elissaios Kontis
- 2ndDepartment of Surgery, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - Konstantinos Stamatis
- 2ndDepartment of Surgery, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - Evanthia Zampeli
- Department of Gastroenterology Alexandra General Hospital, Athens Greece
| | - Despoina Myoteri
- Department of Pathology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | | | - Eirini Pantiora
- 2ndDepartment of Surgery, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - Georgios Fragulidis
- 2ndDepartment of Surgery, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
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Al Laham O, Albrijawy R, Atia F, Shaheen J, AlTabbakh H. Spindle Cell Sarcoma (SCS); a case of primary leiomyosarcoma (LMS) of the sigmoid colon presented as intestinal obstruction. J Surg Case Rep 2021; 2021:rjab515. [PMID: 34876975 PMCID: PMC8643466 DOI: 10.1093/jscr/rjab515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/25/2021] [Indexed: 11/12/2022] Open
Abstract
Leiomyosarcoma (LMS) is a common form of soft tissue sarcoma. Primary colonic LMS is an extremely rare entity, comprising 1-2% of gastrointestinal malignancies. Primary mesenchymal sarcomas of the gastrointestinal system are rare and constitute just 0.1-3% of all gastrointestinal tumours. LMS is the most common variant of such tumours and represents just 0.12% of colorectal malignancies. We present a case of a 65-year-old female, who presented to the emergency department with 3 days history of obstipation and generalized abdominal pain. Radiology (X-ray and ultrasound) indicated a large pelvic mass compressing the sigmoid colon and its surrounding structures. Histopathological analysis indicated a primary LMS of the sigmoid colon. Diagnosis is established mostly postoperatively after histopathological evaluation. Prognosis and treatment modalities for this aggressive malignancy remain insufficient. LMS is relatively impervious to chemotherapy/radiotherapy. Our patient was treated by surgical excision of the tumour and referred postoperatively for adjuvant chemotherapy.
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Affiliation(s)
- Omar Al Laham
- Department of Surgery, Al-Mouwasat University Hospital, Mazzah, Damascus, Syria
| | - Reham Albrijawy
- Department of Surgery, Al-Mouwasat University Hospital, Mazzah, Damascus, Syria
| | - Fareed Atia
- Department of Surgery, Al-Mouwasat University Hospital, Mazzah, Damascus, Syria
| | - Jack Shaheen
- Department of Surgery, Al-Mouwasat University Hospital, Mazzah, Damascus, Syria
| | - Hani AlTabbakh
- Department of Surgery, Al-Mouwasat University Hospital, Mazzah, Damascus, Syria
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Laparoscopic Right Hemicolectomy to Curatively Treat Primary Leiomyosarcoma at the Ileocecal Valve. ACG Case Rep J 2021; 8:e00670. [PMID: 34646904 PMCID: PMC8500562 DOI: 10.14309/crj.0000000000000670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/13/2021] [Indexed: 11/17/2022] Open
Abstract
Primary leiomyosarcomas of the colon (PLC) are rare tumors, representing 0.12% of all colon malignancies. We report a 59-year-old man with weight loss, mild anemia, and rectal bleeding. Colonoscopy revealed a 3.2 × 2.6-cm mass at the ileocecal valve. Histopathological examination of the biopsy showed a spindle cell neoplasm that stained positive for smooth muscle actin, caldesmon, and desmin. A diagnosis of PLC was made. Subsequently, a laparoscopic right hemicolectomy was performed, and no local recurrence was noted 6 months after the resection. Given the rarity of PLC, more studies on the clinical features and treatments of this tumor are warranted.
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Wang Y, Wang H, Yuan ZL, Zhao JF, Dong DB, Gao Q. A pooled analysis of risk factors of surgically treated leiomyosarcoma of the colon in adults. World J Surg Oncol 2020; 18:61. [PMID: 32222151 PMCID: PMC7103068 DOI: 10.1186/s12957-020-01838-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/19/2020] [Indexed: 12/20/2022] Open
Abstract
Background This current systematic review aimed to evaluate the role of surgical management and risk factors by pooled cases from all identified patients with colonic leiomyosarcomas. Methods The authors searched the Ovid MEDLINE, Embase, PubMed, and Cochrane databases using the keywords “colonic,” “colon,” and “leiomyosarcoma.” Risk factors of colonic leiomyosarcoma in the pooled cohort were also evaluated. Results Between 1923 and 2019, 41 cases of colonic leiomyosarcoma were identified in 22 (53.7%) males and 19 (46.3%) females, with a mean and median age of 58.7 ± 2.2 years and 56.0 years. According to univariate analysis, smaller tumor size < 8 cm was significantly associated with longer progression-free survival (HR = 6.957, 95% CI 1.405–34.442; p = 0.017), and younger age < 60 years was trending toward better overall survival (HR = 2.765, 95% CI 0.924–8.272; p = 0.069). Conclusions Colonic leiomyosarcomas are rare neoplasms with aggressive clinical behaviors. Age < 60 years and tumor size < 8 cm were favorable factors for patients’ better survival.
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Affiliation(s)
- Yun Wang
- Department of Digestive System, Qinghai University Affiliated Hospital, Xining, 810000, Qinghai, China.,Qinghai University, Xining, 810000, Qinghai, China
| | - Hao Wang
- Department of Intensive Care Medicine, Qinghai Province People's Hospital, Xining, 810007, China
| | - Zhi-Lu Yuan
- Department of General Surgery, Liao Cheng The Third People's Hospital, Liaocheng, 252000, Shandong, People's Republic of China
| | - Jing-Fei Zhao
- Department of General Surgery, Liao Cheng The Third People's Hospital, Liaocheng, 252000, Shandong, People's Republic of China
| | - Dian-Bo Dong
- Department of Anorectal Medicine, Liao Cheng People's Hospital, Liaocheng, 252000, Shandong, People's Republic of China
| | - Qian Gao
- Department of Digestive System, Qinghai University Affiliated Hospital, Xining, 810000, Qinghai, China.
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Primary Leiomyosarcoma of the Colon: A Report of Two Cases, Review of the Literature, and Association with Immunosuppression for IBD and Rheumatoid Arthritis. Case Rep Surg 2018; 2018:6824643. [PMID: 29780656 PMCID: PMC5892970 DOI: 10.1155/2018/6824643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 01/10/2018] [Indexed: 01/17/2023] Open
Abstract
Primary leiomyosarcomas (LMS) of the colon are rare and aggressive neoplasms and have been infrequently reported in the literature. These tumors are more aggressive and have poorer prognoses than adenocarcinoma of the colon and are often mistaken as such on initial evaluation. While the former has a clear association with inflammatory bowel disease (IBD), this correlation is not known to exist with LMS and IBD. Nor is there a known link between LMS and the immunosuppression for IBD, despite the known association between malignancy and immunosuppression for other diseases. Due to the low prevalence of this disease entity, there is limited knowledge and literature on the approach to diagnosing and treating these neoplasms, especially in the setting of the aforementioned comorbidities. Here, we describe two cases of this rare entity, presenting in two different circumstances: one in the setting of immunosuppression for IBD and arthritis, with a synchronous urothelial carcinoma, and the second appearing as the source of an acute abdomen. Both diagnoses were established following pathologic analysis.
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Anzai H, Nozawa H, Tanaka J, Yasuda K, Otani K, Nishikawa T, Tanaka T, Kiyomatsu T, Hata K, Kawai K, Ushiku T, Ishihara S, Takano T, Fukayama M, Watanabe T. Giant leiomyosarcoma of the rectum with lymph node metastasis: A case report and review of the literature. Int J Surg Case Rep 2017; 34:27-31. [PMID: 28342361 PMCID: PMC5367864 DOI: 10.1016/j.ijscr.2017.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/06/2017] [Accepted: 03/06/2017] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Leiomyosarcoma of the gastrointestinal tract is very rare, with a reported frequency of less than 0.1% of all malignancies of the colorectum. It is important to diagnose leiomyosarcoma definitively by immunohistochemical profiling of smooth muscle actin, desmin, and CD34. True leiomyosarcoma of the colorectum diagnosed by immunnohistochemical profiling is extremely rare that only 13 reports have been published in reviews of resected gastrointestinal mesenchymal tumors after 1998. In addition, lymph node involvement is rare in patients with leiomyosarcoma. Herein we report an aggressive case of LMS in a rectosigmoid lesion with lymph node metastasis. CASE PRESENTATION A 76-year-old woman visited our hospital complaining of intermittent anal bleeding that had lasted 5 months. Image studies aiming at examining the cause of her anal bleeding revealed a tumor located between the right ovary, uterus, and the rectosigmoid. Histopathology of biopsied materials from the colonoscopy suggested a malignant tumor of mesenchymal origin. Surgical resection was performed with curative intent. The tumor was diagnosed as leiomyosarcoma by pathological examination. Moreover, one of the 31 regional lymph nodes retrieved was metastasized by leiomyosarcoma. Eight months later, follow-up CT scans revealed multiple recurrent lesions in the liver and peritoneum. Despite systematic chemotherapy, she deceased 12 months after the surgery. CONCLUSION It is crucial to diagnose leioyosarcoma precisely based on immunohistochemistry, and thereby distinguish it from GIST. Although lymph node metastasis is rare, lymphadenectomy appears to be important for high-risk LMSs to perform R0 resection. Further investigation on leiomyosarcoma cases so far is required to establish standard treatment strategies.
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Affiliation(s)
- Hiroyuki Anzai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Hiroaki Nozawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Junichiro Tanaka
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Koji Yasuda
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kensuke Otani
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takeshi Nishikawa
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshiaki Tanaka
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tomomichi Kiyomatsu
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Keisuke Hata
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazushige Kawai
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshimi Takano
- Department of Oncology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toshiaki Watanabe
- Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Faraj W, El-Kehdy J, Nounou GE, Deeba S, Fakih H, Jabbour M, Haydar A, El Naaj AA, Abou-Alfa GK, O'Reilly EM, Shamseddine A, Khalife M, Mukherji D. Liver resection for metastatic colorectal leiomyosarcoma: a single center experience. J Gastrointest Oncol 2015; 6:E70-6. [PMID: 26487954 DOI: 10.3978/j.issn.2078-6891.2015.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Leiomyosarcoma arising in the colorectum is a rare malignancy of the smooth muscles accounting for less than 1% of gastrointestinal tumors. Surgery remains the most accepted modality for the treatment of this entity however management of liver metastases remains controversial. METHODS & RESULTS From 1998 to 2009, five patients diagnosed with primary leiomyosarcoma of colorectal origin with metastatic liver disease, underwent liver resections at the American University of Beirut Medical Center. The median overall survival was 47 months (range, 7-135 months). CONCLUSIONS Leiomyosarcoma of colorectal origin with liver metastasis is a very rare entity. Long-term survival can be achieved after surgical resection and should be considered for all patients.
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Affiliation(s)
- Walid Faraj
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Jessica El-Kehdy
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Ghina El Nounou
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Samer Deeba
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Hawraa Fakih
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Mark Jabbour
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Ali Haydar
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Abdallah Abou El Naaj
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Ghassan K Abou-Alfa
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Eileen M O'Reilly
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Ali Shamseddine
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Mohamad Khalife
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Deborah Mukherji
- 1 Liver Transplantation and Hepatopancreaticobiliary Surgery, Department of General Surgery, 2 Department of Surgery, 3 Division of Hematology and Oncology, Department of Internal Medicine, 4 Department of Pathology, American University of Beirut Medical Center, Beirut, Lebanon ; 5 Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA ; 6 Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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