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1. Prolonged 14-day continuous infusion of high-dose ifosfamide for patients with relapsed and refractory high-grade osteosarcoma: a retrospective multicentre cohort study

Author

Tirtei, Elisa, Campello, Anna, Sciannameo, Veronica, Asaftei, Sebastian Dorin, Meazza, Cristina, Sironi, Giovanna, Longhi, Alessandra, Ibrahim, Toni, Tamburini, Angela, Coccoli, Luca, Crocco, Fanj, Cagnazzo, Celeste, De Luna, Elvira, Quarello, Paola, Berchialla, Paola, and Fagioli, Franca

Published
2024
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3. Impaired neutrophil-mediated cell death drives Ewing's Sarcoma in the background of Down syndrome.

Author

Peirone, Serena, Tirtei, Elisa, Campello, Anna, Parlato, Caterina, Guarrera, Simonetta, Mareschi, Katia, Marini, Elena, Asaftei, Sebastian Dorin, Bertero, Luca, Papotti, Mauro, Priante, Francesca, Perrone, Sarah, Cereda, Matteo, and Fagioli, Franca

Subjects
EWING'S sarcoma, OSTEOSARCOMA, DOWN syndrome, CELL death, TRANSCRIPTOMES
Abstract

Introduction: Ewing Sarcoma (EWS) has been reported in seven children with Down syndrome (DS). To date, a detailed assessment of this solid tumour in DS patients is yet to be made. Methods: Here,we characterise a chemo-resistantmediastinal EWS in a 2-year-old DS child, the youngest ever reported case, by exploiting sequencing approaches. Results: The tumour showed a neuroectodermal development driven by the EWSR1-FLI1 fusion. The inherited myeloperoxidase deficiency of the patient caused failure of neutrophil-mediated cell death and promoted genomic instability. Discussion: In this context, the tumour underwent genome-wide near haploidisation resulting in a massive overexpression of pro-inflammatory cytokines. Recruitment of defective neutrophils fostered rapid evolution of this EWS. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Musculoskeletal manifestations of childhood cancer and differential diagnosis with juvenile idiopathic arthritis (ONCOREUM): a multicentre, cross-sectional study

Author

Amatruda, M, Atzeni, C, Bertolini, P, Bigucci, B, Caniglia, M, Cappella, M, Cattalini, M, Cefalo, MG, Cellini, M, Cortis, E, Davì, S, De Benedetti, F, Di Cataldo, A, Fabbri, E, Fagioli, F, Fontanili, I, Garaventa, A, Gicchino, MF, Ladogana, S, Locatelli, F, Magnolato, A, Marsili, M, Martino, S, Mascarin, M, Messina, C, Micalizzi, C, Porta, F, Rizzari, C, Civino, Adele, Alighieri, Giovanni, Prete, Eleonora, Caroleo, Anna Maria, Magni-Manzoni, Silvia, Vinti, Luciana, Romano, Micol, Santoro, Nicola, Filocamo, Giovanni, Belotti, Tamara, Santarelli, Francesca, Gorio, Chiara, Ricci, Francesca, Colombini, Antonella, Pastore, Serena, Cesaro, Simone, Barone, Patrizia, Verzegnassi, Federico, Olivieri, Alma Nunzia, Ficara, Monica, Miniaci, Angela, Russo, Giovanna, Gallizzi, Romina, Pericoli, Roberta, Breda, Luciana, Mura, Rossella, Podda, Rosa Anna, Onofrillo, Daniela, Lattanzi, Bianca, Tirtei, Elisa, Maggio, Maria Cristina, De Santis, Raffaela, Consolini, Rita, Arlotta, Annalisa, La Torre, Francesco, Mainardi, Chiara, Pelagatti, Maria Antonietta, Coassin, Elisa, Capolsini, Ilaria, Burnelli, Roberta, Tornesello, Assunta, Soscia, Francesca, De Fanti, Alessandro, Rigante, Donato, Pizzato, Cristina, De Fusco, Carmela, Abate, Massimo Eraldo, Roncadori, Andrea, Rossi, Elisa, Stabile, Giulia, Biondi, Andrea, Lepore, Loredana, Conter, Valentino, Rondelli, Roberto, Pession, Andrea, and Ravelli, Angelo

Published
2021
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6. Biological Sample Collection to Advance Research and Treatment: A Fight Osteosarcoma Through European Research and Euro Ewing Consortium Statement

Author

Onderzoek Beeld, Green, Darrell, van Ewijk, Roelof, Tirtei, Elisa, Andreou, Dimosthenis, Baecklund, Fredrik, Baumhoer, Daniel, Bielack, Stefan S., Botchu, Rajesh, Boye, Kjetil, Brennan, Bernadette, Capra, Michael, Cottone, Lucia, Dirksen, Uta, Fagioli, Franca, Fernandez, Natalia, Flanagan, Adrienne M., Gambarotti, Marco, Gaspar, Nathalie, Gelderblom, Hans, Gerrand, Craig, Gomez-Mascard, Anne, Hardes, Jendrik, Hecker-Nolting, Stefanie, Kabickova, Edita, Kager, Leo, Kanerva, Jukka, Kester, Lennart A., Kuijjer, Marieke L., Laurence, Valérie, Lervat, Cyril, Marchais, Antonin, Marec-Berard, Perrine, Mendes, Cristina, Merks, Johannes H.M., Ory, Benjamin, Palmerini, Emanuela, Pantziarka, Pan, Papakonstantinou, Evgenia, Piperno-Neumann, Sophie, Raciborska, Anna, Roundhill, Elizabeth A., Rutkauskaite, Vilma, Safwat, Akmal, Scotlandi, Katia, Staals, Eric L., Strauss, Sandra J., Surdez, Didier, Sys, Gwen M.L., Tabone, Marie Dominique, Toulmonde, Maud, Valverde, Claudia, van de Sande, Michiel A.J., Wörtler, Klaus, Campbell-Hewson, Quentin, McCabe, Martin G., Nathrath, Michaela, Onderzoek Beeld, Green, Darrell, van Ewijk, Roelof, Tirtei, Elisa, Andreou, Dimosthenis, Baecklund, Fredrik, Baumhoer, Daniel, Bielack, Stefan S., Botchu, Rajesh, Boye, Kjetil, Brennan, Bernadette, Capra, Michael, Cottone, Lucia, Dirksen, Uta, Fagioli, Franca, Fernandez, Natalia, Flanagan, Adrienne M., Gambarotti, Marco, Gaspar, Nathalie, Gelderblom, Hans, Gerrand, Craig, Gomez-Mascard, Anne, Hardes, Jendrik, Hecker-Nolting, Stefanie, Kabickova, Edita, Kager, Leo, Kanerva, Jukka, Kester, Lennart A., Kuijjer, Marieke L., Laurence, Valérie, Lervat, Cyril, Marchais, Antonin, Marec-Berard, Perrine, Mendes, Cristina, Merks, Johannes H.M., Ory, Benjamin, Palmerini, Emanuela, Pantziarka, Pan, Papakonstantinou, Evgenia, Piperno-Neumann, Sophie, Raciborska, Anna, Roundhill, Elizabeth A., Rutkauskaite, Vilma, Safwat, Akmal, Scotlandi, Katia, Staals, Eric L., Strauss, Sandra J., Surdez, Didier, Sys, Gwen M.L., Tabone, Marie Dominique, Toulmonde, Maud, Valverde, Claudia, van de Sande, Michiel A.J., Wörtler, Klaus, Campbell-Hewson, Quentin, McCabe, Martin G., and Nathrath, Michaela

Published
2024

8. Resection of primary tumor in stage 4S neuroblastoma: a second study by the Italian Neuroblastoma Group

Author

Avanzini, Stefano, Buffoni, Isabella, Gigliotti, Anna Rita, Parodi, Stefano, Paraboschi, Irene, Inserra, Alessandro, Dall’Igna, Patrizia, Fagnani, Anna Maria, Martucciello, Giuseppe, Lima, Mario, Caccioppoli, Umberto, Garaventa, Alberto, Conte, Massimo, Granata, Claudio, Sementa, Angela Rita, Tirtei, Elisa, Erminio, Giovanni, and De Bernardi, Bruno

Published
2021
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11. Impaired neutrophil-mediated cell death drives Ewing's Sarcoma in a two years old child with Down Syndrome

Author

Peirone, Serena, primary, Tirtei, Elisa, additional, Campello, Anna, additional, Parlato, Caterina, additional, Guarrera, Simonetta, additional, Mareschi, Katia, additional, Marini, Elena, additional, Asaftei, Sebastian Dorin, additional, Bertero, Luca, additional, Papotti, Mauro, additional, Cereda, Matteo, additional, and Fagioli, Franca, additional

Published
2023
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12. Implications of an Underlying Beckwith–Wiedemann Syndrome for Wilms Tumor Treatment Strategies

Author

Quarello, Paola, primary, Carli, Diana, additional, Biasoni, Davide, additional, Gerocarni Nappo, Simona, additional, Morosi, Carlo, additional, Cotti, Roberta, additional, Garelli, Emanuela, additional, Zucchetti, Giulia, additional, Spadea, Manuela, additional, Tirtei, Elisa, additional, Spreafico, Filippo, additional, and Fagioli, Franca, additional

Published
2023
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14. Report from the 4th European Bone Sarcoma Networking meeting: focus on osteosarcoma

Author

Strauss, Sandra J., Anninga, Jakob, Baglio, Rubina, Baumhoer, Daniel, Behjati, Sam, Bielack, Stefan, Boye, Kjetil, Broto, Javier M., Cleton-Jansen, Anne-Marie, Degasperi, Andrea, Evans, Abigail, Fagioli, Franca, Fiocco, Marta, Gaspar, Nathalie, Heymann, Dominique, Hindi, Nadia, Lancia, Carlo, Myklebost, Ola, Nathrath, Michaela, Redini, Francoise, Scotlandi, Katia, Tirtei, Elisa, Vanden Eynden, Michel, and Whelan, Jeremy

Published
2018
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16. Musculoskeletal manifestations of childhood cancer and differential diagnosis with juvenile idiopathic arthritis (ONCOREUM): a multicentre, cross-sectional study

Author

Civino, Adele, primary, Alighieri, Giovanni, additional, Prete, Eleonora, additional, Caroleo, Anna Maria, additional, Magni-Manzoni, Silvia, additional, Vinti, Luciana, additional, Romano, Micol, additional, Santoro, Nicola, additional, Filocamo, Giovanni, additional, Belotti, Tamara, additional, Santarelli, Francesca, additional, Gorio, Chiara, additional, Ricci, Francesca, additional, Colombini, Antonella, additional, Pastore, Serena, additional, Cesaro, Simone, additional, Barone, Patrizia, additional, Verzegnassi, Federico, additional, Olivieri, Alma Nunzia, additional, Ficara, Monica, additional, Miniaci, Angela, additional, Russo, Giovanna, additional, Gallizzi, Romina, additional, Pericoli, Roberta, additional, Breda, Luciana, additional, Mura, Rossella, additional, Podda, Rosa Anna, additional, Onofrillo, Daniela, additional, Lattanzi, Bianca, additional, Tirtei, Elisa, additional, Maggio, Maria Cristina, additional, De Santis, Raffaela, additional, Consolini, Rita, additional, Arlotta, Annalisa, additional, La Torre, Francesco, additional, Mainardi, Chiara, additional, Pelagatti, Maria Antonietta, additional, Coassin, Elisa, additional, Capolsini, Ilaria, additional, Burnelli, Roberta, additional, Tornesello, Assunta, additional, Soscia, Francesca, additional, De Fanti, Alessandro, additional, Rigante, Donato, additional, Pizzato, Cristina, additional, De Fusco, Carmela, additional, Abate, Massimo Eraldo, additional, Roncadori, Andrea, additional, Rossi, Elisa, additional, Stabile, Giulia, additional, Biondi, Andrea, additional, Lepore, Loredana, additional, Conter, Valentino, additional, Rondelli, Roberto, additional, Pession, Andrea, additional, Ravelli, Angelo, additional, Amatruda, M, additional, Atzeni, C, additional, Bertolini, P, additional, Bigucci, B, additional, Caniglia, M, additional, Cappella, M, additional, Cattalini, M, additional, Cefalo, MG, additional, Cellini, M, additional, Cortis, E, additional, Davì, S, additional, De Benedetti, F, additional, Di Cataldo, A, additional, Fabbri, E, additional, Fagioli, F, additional, Fontanili, I, additional, Garaventa, A, additional, Gicchino, MF, additional, Ladogana, S, additional, Locatelli, F, additional, Magnolato, A, additional, Marsili, M, additional, Martino, S, additional, Mascarin, M, additional, Messina, C, additional, Micalizzi, C, additional, Porta, F, additional, and Rizzari, C, additional

Published
2021
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17. Front-Line Window Therapy with Temozolomide and Irinotecan in Patients with Primary Disseminated Multifocal Ewing Sarcoma: Results of the ISG/AIEOP EW-2 Study

Author

Asaftei, Sebastian Dorin, primary, Puma, Nadia, additional, Paioli, Anna, additional, Petraz, Marco, additional, Morosi, Carlo, additional, Podda, Marta, additional, Tamburini, Angela, additional, Palmerini, Emanuela, additional, Coccoli, Luca, additional, Grignani, Giovanni, additional, Manzitti, Carla, additional, Bertulli, Rossella, additional, De Leonardis, Francesco, additional, Rabusin, Marco, additional, Campello, Anna, additional, Tirtei, Elisa, additional, Picci, Piero, additional, Prete, Arcangelo, additional, Longhi, Alessandra, additional, Fagioli, Franca, additional, and Luksch, Roberto, additional

Published
2021
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21. Resection of primary tumor in stage 4S neuroblastoma: a second study by the Italian Neuroblastoma Group

Author

Avanzini, Stefano, primary, Buffoni, Isabella, additional, Gigliotti, Anna Rita, additional, Parodi, Stefano, additional, Paraboschi, Irene, additional, Inserra, Alessandro, additional, Dall’Igna, Patrizia, additional, Fagnani, Anna Maria, additional, Martucciello, Giuseppe, additional, Lima, Mario, additional, Caccioppoli, Umberto, additional, Garaventa, Alberto, additional, Conte, Massimo, additional, Granata, Claudio, additional, Sementa, Angela Rita, additional, Tirtei, Elisa, additional, Erminio, Giovanni, additional, and De Bernardi, Bruno, additional

Published
2020
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25. Additional file 1: of Stage 4 s neuroblastoma: features, management and outcome of 268 cases from the Italian Neuroblastoma Registry

Author

Bernardi, Bruno, Cataldo, Andrea, Garaventa, Alberto, Massirio, Paolo, Viscardi, Elisabetta, Podda, Marta, Castellano, Aurora, D’Angelo, Paolo, Tirtei, Elisa, Fraia Melchionda, Vetrella, Simona, Leonardis, Francesco, D’Ippolito, Carmelita, Tondo, Annalisa, Nonnis, Antonella, Erminio, Giovanni, Gigliotti, Anna, Mazzocco, Katia, and Haupt, Riccardo

Subjects
neoplasms
Abstract

Table S1. Outlines of therapy for stage 4 s neuroblastoma patients (DOCX 16 kb)

Published
2019
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27. HaTSPiL: A modular pipeline for high-throughput sequencing data analysis

Author

Morandi, Edoardo, primary, Cereda, Matteo, additional, Incarnato, Danny, additional, Parlato, Caterina, additional, Basile, Giulia, additional, Anselmi, Francesca, additional, Lauria, Andrea, additional, Simon, Lisa Marie, additional, Laurence Polignano, Isabelle, additional, Arruga, Francesca, additional, Deaglio, Silvia, additional, Tirtei, Elisa, additional, Fagioli, Franca, additional, and Oliviero, Salvatore, additional

Published
2019
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28. Stage 4 s neuroblastoma: features, management and outcome of 268 cases from the Italian Neuroblastoma Registry

Author

De Bernardi, Bruno, primary, Di Cataldo, Andrea, additional, Garaventa, Alberto, additional, Massirio, Paolo, additional, Viscardi, Elisabetta, additional, Podda, Marta Giorgia, additional, Castellano, Aurora, additional, D’Angelo, Paolo, additional, Tirtei, Elisa, additional, Melchionda, Fraia, additional, Vetrella, Simona, additional, De Leonardis, Francesco, additional, D’Ippolito, Carmelita, additional, Tondo, Annalisa, additional, Nonnis, Antonella, additional, Erminio, Giovanni, additional, Gigliotti, Anna Rita, additional, Mazzocco, Katia, additional, and Haupt, Riccardo, additional

Published
2019
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31. Perioperative management of hypertensive neuroblastoma: A study from the Italian Group of Pediatric Surgical Oncologists (GICOP)

Author

Pio, Luca, primary, Avanzini, Stefano, additional, Mattioli, Girolamo, additional, Martucciello, Giuseppe, additional, Sementa, Angela Rita, additional, Conte, Massimo, additional, Gigliotti, Annarita, additional, Granata, Claudio, additional, Leva, Ernesto, additional, Fagnani, Anna Maria, additional, Caccioppoli, Umberto, additional, Tedesco, Nino, additional, Schleef, Jurgen, additional, Tirtei, Elisa, additional, Siracusa, Fortunato, additional, D'Angelo, Paolo, additional, Lelli Chiesa, Pierluigi, additional, Miglionico, Lucia, additional, Noccioli, Bruno, additional, Severi, Elisa, additional, Carlini, Claudio, additional, Vaccarella, Francesco, additional, Camoglio, Francesco, additional, Cesaro, Simone, additional, Narciso, Alessandra, additional, Riccipetitoni, Giovanna, additional, Cecchetto, Giovanni, additional, and Inserra, Alessandro, additional

Published
2017
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36. Resection of primary tumor in stage 4S neuroblastoma: a second study by the Italian Neuroblastoma Group

Author

Anna Maria Fagnani, Anna Rita Gigliotti, Alberto Garaventa, Claudio Granata, Isabella Buffoni, Stefano Avanzini, Irene Paraboschi, Giuseppe Martucciello, Stefano Parodi, Mario Lima, Angela Rita Sementa, Patrizia Dall'Igna, Alessandro Inserra, Massimo Conte, Umberto Caccioppoli, Elisa Tirtei, Bruno De Bernardi, Giovanni Erminio, Avanzini, Stefano, Buffoni, Isabella, Gigliotti, Anna Rita, Parodi, Stefano, Paraboschi, Irene, Inserra, Alessandro, Dall’Igna, Patrizia, Fagnani, Anna Maria, Martucciello, Giuseppe, Lima, Mario, Caccioppoli, Umberto, Garaventa, Alberto, Conte, Massimo, Granata, Claudio, Sementa, Angela Rita, Tirtei, Elisa, Erminio, Giovanni, and De Bernardi, Bruno

Subjects
Male, medicine.medical_specialty, Neuroblastoma· Stage 4S· Surgery· Primary tumor resection, Tumor resection, Neuroblastoma, Primary tumor resection, Stage 4S, Surgery, Cohort Studies, Disease Progression, Female, Humans, Infant, Italy, Neoplasm Staging, Treatment Outcome, Resection, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Pediatric surgery, medicine, In patient, business.industry, General Medicine, medicine.disease, Primary tumor, Pediatrics, Perinatology and Child Health, Cohort, Settore MED/20, Stage 4S Neuroblastoma, 030211 gastroenterology & hepatology, business
Abstract

Purpose To clarify the role of primary tumor resection in stage 4S neuroblastoma. Methods We investigated a cohort of 172 infants diagnosed with stage 4S neuroblastoma between 1994 and 2013. Of 160 evaluable patients, 62 underwent upfront resection of the primary tumor and 98 did not. Results Five-year progression-free and overall survival were significantly better in those who had undergone upfront surgery (83.6% vs 64.2% and 96.8% vs 85.7%, respectively). One post-operative death and four non-fatal complications occurred in the resection group. Three patients who had not undergone resection died of chemotherapy-related toxicity. Thirteen patients underwent late surgery to remove a residual tumor, without complications: all but one alive. Outcomes were better in patients diagnosed from 2000 onwards. Conclusion Infants diagnosed with stage 4S neuroblastoma who underwent upfront tumor resection had a better outcome. However, this result cannot be definitely attributed to surgery, since these patients were selected on the basis of their favorable presenting features. Although the question of whether to operate or not at disease onset is still unsolved, this study confirms the importance of obtaining enough adequate tumor tissue to enable histological and biological studies to properly address treatment, to achieve the best possible outcome.

Published
2021

37. Biological Sample Collection to Advance Research and Treatment: A Fight Osteosarcoma Through European Research and Euro Ewing Consortium Statement.

Author

Green D, van Ewijk R, Tirtei E, Andreou D, Baecklund F, Baumhoer D, Bielack SS, Botchu R, Boye K, Brennan B, Capra M, Cottone L, Dirksen U, Fagioli F, Fernandez N, Flanagan AM, Gambarotti M, Gaspar N, Gelderblom H, Gerrand C, Gomez-Mascard A, Hardes J, Hecker-Nolting S, Kabickova E, Kager L, Kanerva J, Kester LA, Kuijjer ML, Laurence V, Lervat C, Marchais A, Marec-Berard P, Mendes C, Merks JHM, Ory B, Palmerini E, Pantziarka P, Papakonstantinou E, Piperno-Neumann S, Raciborska A, Roundhill EA, Rutkauskaite V, Safwat A, Scotlandi K, Staals EL, Strauss SJ, Surdez D, Sys GML, Tabone MD, Toulmonde M, Valverde C, van de Sande MAJ, Wörtler K, Campbell-Hewson Q, McCabe MG, and Nathrath M

Subjects
Humans, Europe, Biomarkers, Tumor, Biological Specimen Banks, Osteosarcoma therapy, Osteosarcoma pathology, Osteosarcoma diagnosis, Sarcoma, Ewing therapy, Sarcoma, Ewing pathology, Sarcoma, Ewing diagnosis, Bone Neoplasms therapy, Bone Neoplasms pathology, Specimen Handling methods, Specimen Handling standards
Abstract

Osteosarcoma and Ewing sarcoma are bone tumors mostly diagnosed in children, adolescents, and young adults. Despite multimodal therapy, morbidity is high and survival rates remain low, especially in the metastatic disease setting. Trials investigating targeted therapies and immunotherapies have not been groundbreaking. Better understanding of biological subgroups, the role of the tumor immune microenvironment, factors that promote metastasis, and clinical biomarkers of prognosis and drug response are required to make progress. A prerequisite to achieve desired success is a thorough, systematic, and clinically linked biological analysis of patient samples, but disease rarity and tissue processing challenges such as logistics and infrastructure have contributed to a lack of relevant samples for clinical care and research. There is a need for a Europe-wide framework to be implemented for the adequate and minimal sampling, processing, storage, and analysis of patient samples. Two international panels of scientists, clinicians, and patient and parent advocates have formed the Fight Osteosarcoma Through European Research consortium and the Euro Ewing Consortium. The consortia shared their expertise and institutional practices to formulate new guidelines. We report new reference standards for adequate and minimally required sampling (time points, diagnostic samples, and liquid biopsy tubes), handling, and biobanking to enable advanced biological studies in bone sarcoma. We describe standards for analysis and annotation to drive collaboration and data harmonization with practical, legal, and ethical considerations. This position paper provides comprehensive guidelines that should become the new standards of care that will accelerate scientific progress, promote collaboration, and improve outcomes., (©2024 The Authors; Published by the American Association for Cancer Research.)

Published
2024
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38. Survival after Second and Subsequent Recurrences in Osteosarcoma: A Retrospective Multicenter Analysis.

Author

Tirtei E, Asaftei SD, Manicone R, Cesari M, Paioli A, Rocca M, Ferrari S, and Fagioli F

Abstract

Purpose Osteosarcoma (OS) is the most common primary bone tumor. Despite complete surgical removal and intensive chemotherapeutic treatment, 30%-35% of patients with OS have local or systemic recurrence. Some patients survive multiple recurrences, but overall survival after OS recurrence is poor. This analysis aims to describe and identify factors influencing post-relapse survival (PRS) after a second OS relapse. Methods This is a retrospective analysis of 60 patients with a second relapse of OS of the extremities in 2 Italian centers between 2003 and 2013. Results Treatment for first and subsequent relapses was planned according to institutional guidelines. After complete surgical remission (CSR) following the first recurrence, patients experienced a second OS relapse with a median disease-free interval (DFI) of 6 months. Lung disease was prevalent: 44 patients (76%) had pulmonary metastases. Survival after the second relapse was 22% at 5 years. Lung disease only correlated with better survival at 5 years (33.6%) compared with other sites of recurrence (5%; p = 0.008). Patients with a single pulmonary lesion had a better 5-year second PRS (42%; p = 0.02). Patients who achieved a second CSR had a 5-year second PRS of 33.4%. Chemotherapy (p<0.001) benefited patients without a third CSR. Conclusions This analysis confirms the importance of an aggressive, repeated surgical approach. Lung metastases only, the number of lesions, DFI and CSR influenced survival. It also confirms the importance of chemotherapy in patients in whom surgical treatment is not feasible.

Published
2017
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