Would you offer adjuvant chemotherapy for patient with a large, high-grade leiomyosarcoma of the colon who underwent an R0 resection with no lymph node involvement?

One needs to ensure that GIST has been ruled out and this represents the very rare, true LMS of the GI tract. These do tend to behave aggressively, but data on the efficacy of standard systemic therapy in this specific subset is very limited. Given that, the standard of care has to be close observation and consider treatment if/when measurable/evaluable disease develops, to justify risks and benefits. Clearly, this scenario requires a detailed discussion with the patient to personalize the indiv...