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Raff JP, Sege J, Braiotta R, Jafri FN, Cook B, Steiner-Grossman P, Cohen F. The Impact of a Narrative Medicine Life Story Pilot Program on Press Ganey™ Scores in an Outpatient Cancer Center. HEALTH COMMUNICATION 2024; 39:2079-2089. [PMID: 37691170 DOI: 10.1080/10410236.2023.2255761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Oncology patients face challenges beyond those directly affecting their cancer management. Guided personal narrative programs have been shown to help patients with chronic conditions and life-framing events. Few such narrative programs have been reported for cancer patients or analyzed for their impact on patient experience. We established our Life Story Narrative Program, modeled on the United States Veterans Affairs' "My Life, My Story" for outpatient oncology patients in our hospital's cancer center. Press Ganey™ patient experience scores from program participants were compared retrospectively with scores from patients who were not participants. Over an eight-month period, we invited 30 cancer center outpatients to participate. Twenty-seven individuals accepted, and 18 had their stories edited, approved, and scanned into their electronic health record. Cohort matching yielded a control arm consisting of 255 responses from 48 surveys, while the intervention arm consisted of 68 responses from 12 surveys. 78.4% of responses from the control arm were rated 5 compared with 100% in the intervention arm. The mean Press Ganey™ score response in the control arm was 4.71 compared with 5.00 from the intervention arm. Wilcoxon U value was 10,540 with p < .001. An outpatient narrative medicine program for cancer patients to tell their life stories can easily be organized. Patients were willing to participate, enrollment was brisk, and the use of resources was limited. Although our sample size was small, participation in our Life Story Narrative Pilot Program resulted in a statistically significant improvement in Press Ganey™ scores.
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Affiliation(s)
- Joshua P Raff
- Section of Medical Oncology and Hematology, White Plains Hospital
| | | | | | | | - Brennan Cook
- Robert Wood Johnson School of Medicine, Rutgers University
| | - Penny Steiner-Grossman
- Departments of Family & Social Medicine and Pediatrics, Albert Einstein College of Medicine
| | - Fredda Cohen
- Department of Pastoral Care and Education, White Plains Hospital
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Artioli G, Deiana L, Bertuol M, Casella G, Guasconi M, Foà C, De Simone R, Sarli L, Bonacaro A. Evaluating a nurse-led narrative interview intervention with cancer patients with a first diagnosis: A feasibility study. Heliyon 2024; 10:e31802. [PMID: 38868003 PMCID: PMC11167297 DOI: 10.1016/j.heliyon.2024.e31802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/14/2024] Open
Abstract
Narrative Medicine and Nursing are clinical-supporting intervention methodologies that aim to enhance professionals' communication skills and place patients at the heart of their therapeutic path. A narrative interview (NI) is a communication tool between practitioner and patient. The role of NI is debated extensively in the literature, but no studies focus on its use by nurses responsible for first-diagnosed cancer patients. This study aimed to evaluate the feasibility and utility of NI, carried out by Nurses, in managing people recently diagnosed with cancer. A pilot mixed-methods study with before-and-after-intervention evaluation, qualitative longitudinal data analysis, and concurrent data triangulation was conducted. The Mini-Mental Adjustment to Cancer assessed disease adaptation, while the Psychological Distress Inventory investigated psychological distress. The qualitative analysis of the narrative interviews assessed the usefulness of this intervention. 13 out of 14 eligible patients took voluntary part in the study. Of those, 9 (69 %) completed T1 and T2 questionnaires and NI. The following five themes emerged from thematic analysis: reaction to the disease, feelings related to the new condition of life, changes, importance of relationships and perception of care. Patients reported being highly stressed and recognized the importance of a supporting social network for better coping with the condition. The adoption of an NI approach at the time of cancer diagnosis is feasible. Due to the limited sample size, it is unclear if NI may positively impact psychological distress in this patient population. Further studies would benefit from the integration of an additional investigation tool aiming to clarify whether NI promotes disease awareness in cancer patients. Furthermore, the recruitment of a larger sample is equally recommended.
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Affiliation(s)
- Giovanna Artioli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Laura Deiana
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Maria Bertuol
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Giovanna Casella
- University of Parma, Department of Medicine and Surgery, Parma, Italy
- “Azienda Unità Sanitaria Locale” of Piacenza, Piacenza, Italy
| | - Massimo Guasconi
- University of Parma, Department of Medicine and Surgery, Parma, Italy
- “Azienda Unità Sanitaria Locale” of Piacenza, Piacenza, Italy
| | - Chiara Foà
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | | | - Leopoldo Sarli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Antonio Bonacaro
- University of Parma, Department of Medicine and Surgery, Parma, Italy
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Fabi A, Rossi A, Mocini E, Cardinali L, Bonavolontà V, Cenci C, Magno S, Barberi V, Moretti A, Besharat ZM, Iolascon G, Baldari C, Ferretti E, Botticelli A, Paris I, Scambia G, Migliaccio S. An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients. Curr Oncol Rep 2024; 26:346-358. [PMID: 38400984 PMCID: PMC11021235 DOI: 10.1007/s11912-024-01500-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Breast cancer (BC) treatment has recently been revolutionized by the introduction of newer targeted agents, that helped tailoring therapies around the single patient. Along with increased survival rates, a careful evaluation of diet, lifestyle habits, physical activity, emotional and psychological experiences linked to the treatment journey, is now mandatory. However, a true proposal for an omnicomprehensive and "integrative" approach is still lacking in literature. METHODS A scientific board of internationally recognized specialists throughout different disciplines designed a shared proposal of holistic approach for BC patients. RESULTS A narrative review, containing information on BC treatment, endocrinological and diet aspects, physical activity, rehabilitation, integrative medicine, and digital narrative medicine, was developed. CONCLUSIONS In the context of a patient-centered care, BC treatment cannot be separated from a patient's long-term follow-up and care, and an organized interdisciplinary collaboration is the future in this disease's cure, to make sure that our patients will live longer and better. TRIAL REGISTRATION NCT05893368: New Model for Integrating Person-based Care (PbC) in the Treatment of Advanced HER2-negative Breast Cancer (PERGIQUAL). Registration date: 29th May 2023.
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Affiliation(s)
- Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Alessandro Rossi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Ludovica Cardinali
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
- Bone Metabolic Diseases Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valerio Bonavolontà
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | | | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vittoria Barberi
- Medical Oncology 1, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Antimo Moretti
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Giovanni Iolascon
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
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Bianchini C, Bonomo P, Bossi P, Caccialanza R, Fabi A. Bridging gaps in cancer cachexia Care: Current insights and future perspectives. Cancer Treat Rev 2024; 125:102717. [PMID: 38518714 DOI: 10.1016/j.ctrv.2024.102717] [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: 12/19/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Cachexia is characterized by severe weight loss and skeletal muscle depletion, and is a threat to cancer patients by worsening their prognosis. International guidelines set indications for the screening and diagnosis of cancer cachexia and suggest interventions (nutritional support, physical exercise, and pharmacological treatments). Nevertheless, real-life experience not always aligns with such indications. We aimed to review the current state of the field and the main advancements, with a focus on real-life clinical practice from the perspectives of oncologists, nutrition professionals, and radiologists. Pragmatic solutions are proposed to improve the current management of the disease, emphasizing the importance of increasing awareness of clinical nutrition's benefits, fostering multidisciplinary collaboration, promoting early identification of at-risk patients, and leveraging available resources. Given the distinct needs of patients who are receiving oncologic anti-cancer treatments and those in the follow-up phase, the use of tailored approaches is encouraged. The pivotal role of healthcare professionals in managing patients in active treatment is highlighted, while patient and caregiver empowerment should be strengthened in the follow-up phase. Telemedicine and web-based applications represent valuable tools for continuous monitoring of patients, facilitating timely and personalized intervention through effective communication between patients and healthcare providers. These actions can potentially improve the outcomes, well-being, and survival of cancer patients with cachexia.
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Affiliation(s)
| | - Pierluigi Bonomo
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Paolo Bossi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS Rome, Italy
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Liu TH, Vernon-Cwik A, Tun S. Examining a Novel Legacy Activity for Elders: Oral Histories as Produced Stories. Palliat Med Rep 2024; 5:25-33. [PMID: 38249833 PMCID: PMC10797308 DOI: 10.1089/pmr.2023.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 01/23/2024] Open
Abstract
Background Many African American elders who participated in The Great Migration are in the latter years of their lives. One way to maintain their memories and those of elders at large is through legacy activities, projects that initiate a life review process resulting in a product surviving after an individual's death. However, literature on culturally attuned legacy activities as well as measurement of impact are limited. Objectives This project sought to introduce a novel legacy activity for elders-the oral history as produced aural self-story-detailing its creation and examining its therapeutic efficacy. Design Setting and Subjects Nine African American elders who experienced The Great Migration receiving care from an urban, geriatric clinic were recruited. Oral histories were conducted, produced into aural self-stories, and examined with follow-up interviews and a project evaluation survey. Qualitative analysis of the follow-up interview and a project evaluation survey were used to ascertain therapeutic outcomes. Results : All participants recommended the project and found self-story listening meaningful or beneficial. Qualitative interviews produced 13 codes; the five most frequent were reflection/contemplation (n = 18), sentimentality/positive affect and affirmation/enlightenment (n = 10), as well as empathy/gratitude and curiosity/intrigue/peculiarity (n = 7). Conclusion : Our project suggests that aural self-stories produced from oral histories enhance the current elder legacy activity landscape by facilitating meaning and existential affirmation, additionally leaving a product for subsequent generations. Future studies include comparison to existing legacy interventions and project examination in additional elder populations.
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Affiliation(s)
- Tony H. Liu
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | - Sandy Tun
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
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Ferraris G, Coppini V, Ferrari MV, Monzani D, Grasso R, Pravettoni G. Understanding Reasons for Cancer Disparities in Italy: A Qualitative Study of Barriers and Needs of Cancer Patients and Healthcare Providers. Cancer Control 2024; 31:10732748241258589. [PMID: 38897992 PMCID: PMC11189013 DOI: 10.1177/10732748241258589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/16/2024] [Accepted: 05/10/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The second leading cause of death in Italy is cancer. Substantial disparities persist in the level of care and outcomes for cancer patients across various communities, hospitals, and regions in Italy. While substantial progress has been made in medical research and treatment options, these advancements tend to disproportionately benefit the wealthier, better-educated, and more privileged areas and portions of the population. Therefore, the primary aim of the current study is to explore possible reasons for inequalities in access to and utilisation of care from the perspective of cancer patients, who are recipients of these treatments, and healthcare providers, who are responsible for their administration. METHODS After being recruited through social media platforms, patients' organisations, and hospital websites, cancer patients (n = 22) and healthcare providers (n = 16) from various Italian regions participated in online focus group discussions on disparities in access to and provision of care. Video and audio recordings of the interviews were analysed using Thematic analysis. RESULTS Among cancer patients, 7 themes were identified, while 6 themes emerged from the healthcare providers highlighting encountered barriers and unmet needs in cancer care. Most of these emerging themes are common to both groups, such as geographical disparities, information deficiencies, and the importance of psycho-oncological support. However, several themes are specific to each group, for instance, cancer patients highlight the financial burden and the poor interactions with healthcare providers, while healthcare providers emphasise the necessity of establishing a stronger specialists' network and integrating clinical practice and research. CONCLUSION Current findings reveal persistent challenges in cancer care, including long waiting lists and regional disparities, highlighting the need for inclusive healthcare strategies. The value of psycho-oncological support is underscored, as well as the potential of the Internet's use for informational needs, emphasising the imperative for improved awareness and communication to overcome disparities in cancer care.
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Affiliation(s)
- Giulia Ferraris
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Veronica Coppini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Vittoria Ferrari
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Laboratory of Behavioral Observation and Research on Human Development, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Roberto Grasso
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Cercato MC, Pierpaoli S, Pazienza RM, Terrenato I, Guadagnuolo C, Cenci C, Nappi RE. Digital integrated dramatherapy: A feasibility study in women undergoing assisted reproductive technology. Front Psychol 2022; 13:1045090. [PMID: 36591103 PMCID: PMC9802005 DOI: 10.3389/fpsyg.2022.1045090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background Dramatherapy is a practice of working and playing that uses action methods to facilitate creativity, imagination, learning, insight and growth. Methods A pilot study of Digital Integrated Dramatherapy, recruiting women from the digital community "Parole Fertili," undergoing assisted reproductive technology. On the basis of a previous blended experience, a program based on remote sessions was conducted on a dedicated platform. Results A total of 22 women participated in the same intervention in three groups. Participants assessed the feasibility and utility of the method, both in the synchronous and asynchronous phases. The group had a fundamental role: the participants were supportive, and therapeutic benefits were due to strengthening and resilience obtained through a dialogue with other women. Using metaphors, the participants could move from the narration of the Assisted Reproductive Technology pathway to creative and corporeal expression. Conclusion The study showed that a group based on Digital Integrated Dramatherapy might help women face very difficult emotions by promoting creativity and internal resources.
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Affiliation(s)
- Maria Cecilia Cercato
- Epidemiology and Cancer Registry Unit, IRCCS–Regina Elena National Cancer Institute, Rome, Italy
| | - Sandra Pierpaoli
- CDI narrAZIONI, Rome, Italy,Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS – Regina Elena National Cancer Institute, Rome, Italy
| | | | - Irene Terrenato
- Clinical Trial Center, Biostatistics and Bioinformatics, IRCCS – Regina Elena National Cancer Institute, Rome, Italy,*Correspondence: Irene Terrenato,
| | | | | | - Rossella E. Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy,Unit of Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS–S. Matteo Foundation, Pavia, Italy
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Cercato MC, Vari S, Maggi G, Faltyn W, Onesti CE, Baldi J, Scotto di Uccio A, Terrenato I, Molinaro C, Scarinci V, Servoli F, Cenci C, Biagini R, Ferraresi V. Narrative Medicine: A Digital Diary in the Management of Bone and Soft Tissue Sarcoma Patients. Preliminary Results of a Multidisciplinary Pilot Study. J Clin Med 2022; 11:406. [PMID: 35054100 PMCID: PMC8779279 DOI: 10.3390/jcm11020406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 12/10/2022] Open
Abstract
BACKGROUND Guidelines for the implementation of narrative medicine in clinical practice exist; however, in Italy, no standard methodology is currently available for the management of oncological patients. Since 2017, at the "Regina Elena" National Cancer Institute, studies using "digital narrative diaries" (DNMLAB platform) have been carried out; this article focuses on a pilot, uncontrolled, real-life study aiming to evaluate the utility of DNM integrated with the care pathway of patients with bone and limb soft tissue sarcomas. METHODS Adult patients completed the diary during treatment or follow-up by writing their narrative guided by a set of narrative prompts. The endpoints were: (a) patients' opinions about therapeutic alliance, awareness, and coping ability; (b) healthcare professionals' (HCPs') opinions about communication, therapeutic alliance, and information collection. Open- and closed-ended questions (Likert score: 1-5) were used to assess the items. RESULTS At the interim analysis of data from seven patients and five HCPs, DNM was shown to improve: (a) the expression of patients' point of view, the perception of effective taking charge, disease awareness, and self-empowerment (score: 4.8/5); (b) patients' communication, relationships, and illness knowledge (score: 4.6-4.8/5). CONCLUSIONS The preliminary results supported the need to integrate patients' narratives with clinical data and encourage further research.
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Affiliation(s)
- Maria Cecilia Cercato
- Epidemiology and Tumor Registry Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (M.C.C.); (C.M.)
| | - Sabrina Vari
- Sarcomas and Rare Tumor Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.E.O.); (V.F.)
| | - Gabriella Maggi
- Psychology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Wioletta Faltyn
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (W.F.); (J.B.); (A.S.d.U.); (R.B.)
| | - Concetta Elisa Onesti
- Sarcomas and Rare Tumor Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.E.O.); (V.F.)
| | - Jacopo Baldi
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (W.F.); (J.B.); (A.S.d.U.); (R.B.)
| | - Alessandra Scotto di Uccio
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (W.F.); (J.B.); (A.S.d.U.); (R.B.)
| | - Irene Terrenato
- Biostatistics and Bioinformatics Unit–Scientific Direction, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy;
| | - Claudia Molinaro
- Epidemiology and Tumor Registry Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (M.C.C.); (C.M.)
| | - Virginia Scarinci
- Digital Library «R. Maceratini», IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (V.S.); (F.S.)
| | - Francesca Servoli
- Digital Library «R. Maceratini», IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (V.S.); (F.S.)
| | - Cristina Cenci
- Digital Narrative Medicine (DNM s.r.l.), 00161 Rome, Italy;
| | - Roberto Biagini
- Oncological Orthopaedics Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (W.F.); (J.B.); (A.S.d.U.); (R.B.)
| | - Virginia Ferraresi
- Sarcomas and Rare Tumor Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.E.O.); (V.F.)
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