Unfavourable Locations Research Articles

Revelation of Genotype × Environment Interaction in Linseed (Linum usitatissimum L.) Under Conventional and Natural Farming Production Systems in the North-Western Himalayas

The development of superior genotypes for use in plant breeding programmes is significantly influenced by the genotype in environment (G × E) interaction. The effects of G × E complicate the improvement of linseed as an important oilseed crop. The present study aimed at assessing the G × E interaction of 30 linseed genotypes for seed yield traits and oil content under conventional and zero-budget natural farming conditions across four locations for two consecutive years (16 different environments) in the North-Western Himalayan region. The AMMI model was used to estimate G × E interaction in the present study. The highest contribution to the total variance belonged to G × E interaction (34.75%), followed by genotype main effects (34.28%). Based on the IPCA1 scores, the most stable genotypes identified with high mean performance for oil content were KL-257 and Nagarkot, and for seed yield, Giza-7 was the most promising genotype. However, genotypes KL-280, KL-285, and Giza-8 showed specific adaptation to the natural production system environments in both years for oil content at locations of Palampur, Bajaura, and Kangra, respectively. Therefore, these genotypes could be recommended specifically under the natural production system in the respective locations. However, the genotypes with stable oil content did not have stable seed yields as well. None of the genotypes that exhibited high oil content stability also exhibited good seed yield stability. In terms of the environment, Palampur was recognised as a favourable location for oil content based on the above average performance, whereas Kangra and Dhaula Kuan were found to be unfavourable locations. In terms of discriminating ability, the natural production system at Palampur showed the highest discrimination, whereas Dhaula Kuan was revealed as the least discriminating environment. These stable and high oil-yielding genotypes are valuable genetic resources for linseed breeding programs for reduced input conditions and marginal environments.

Magnetic equilibrium optimisation and divertor integration in spherical tokamak reactors

Managing the heat exhaust presents one of the main challenges in the design of a spherical tokamak reactor. The development of a robust exhaust solution is intrinsically linked to the optimisation of the plasma equilibrium, together with a compatible poloidal field (PF) system. A multidisciplinary design framework should balance a host of often conflicting physics and engineering requirements and identify a set of self-consistent constraints. This work employs an iterative approach which integrates the core plasma scenario and divertor magnetic topology, ensuring compatibility with the available technology. The aim of this paper is to develop and assess a number of optimal magnetic configurations consistent with the UKAEA STEP Prototype Plant designs. Firstly, we use the Fiesta free-boundary equilibrium code to optimise the global configuration for a chosen double-null scenario, employing both standard and alternative exhaust-handling schemes. We then analyse the local scrape-off layer (SOL) magnetic topology in order to preliminarily assess the anticipated divertor performance. We discuss the advantages and disadvantages of each configuration in terms of the selected divertor metrics, the effects on the core plasma scenario, engineering feasibility, and the implications for whole reactor design.The inner divertor proves to be the most challenging issue in a compact device such as STEP. The small target area and reduced SOL width at the small strike-point radius lead to excessive heat loads beyond the power-handling capacity of standard concepts. We propose an alternative inner X-divertor configuration and compare it with the standard divertor optimised for maximal connection length and poloidal flux expansion. The objective is to achieve the optimal global configuration with a realistic coil set, taking into account space constraints and material limitations. We discuss the feasibility of each considered exhaust solution in STEP, where the PF shaping coils can be placed either in unfavourable locations outside of the toroidal field (TF) coil or mounted inside the TF and operating near their engineering limits.

Electric vehicle route planning using real-world charging infrastructure in Germany

Electric vehicles (EVs) are a way to reduce emissions from mobility. To replace conventional vehicles, EVs must be able to deliver a similar level of comfort on long-distance travel. A key enabler here is an adequate charging infrastructure (CI). In this paper, we evaluate the current CI in Germany, a leading adopter of EVs in Europe. The goal of this evaluation is to understand where innovations and investments need to take place such that overall costs are minimized while user comfort is maximized. We perform this evaluation by analysing travel duration for five typical EVs on 60 routes through Germany. We include non-linear, state-of-charge-dependent charging power as well the non-linear velocity-dependent energy consumption. EVs are modelled after five typically used vehicles in Germany and charging stations are based on real-world data taken from the federal registry. This level of detail in modelling allows for representative results. In our sample, travel time is ∼8% longer when charging compared to non-stop driving. The delay strongly depends on route distance where many routes with <300 km length can be driven non-stop while some extreme cases through areas with unsuitable infrastructure result in 30% more driving time. The necessary breaks were in line with recommendations for truck drivers in Germany. To understand the impact of key technical data we perform a sensitivity analysis. The most relevant factors are start state of charge (SOC) since a low SOC means that typically an additional stop is necessary, often at unfavourable locations. A start SOC of 30% results in 30% additional travel time compared to a non-stop drive. A low energy efficiency and battery capacity of the car (70% of base case) increases travel time by 20%. Increasing charging station power does not have a strong effect since current vehicles cannot charge at 350 kW. • Calculation of time required for recharging in Germany. • 60 routes calculated with 5 vehicle models. • Measured charging curves and energy consumption model for vehicles. • Parameter sweep for battery capacity, charging power, etc.

Comparative analysis of anterior third ventricle approaches

Background. Third ventricle tumors are uncommon and account for only 0.6 - 0.9% of all the brain tumors7. In 1921, Dandy was the first neurosurgeon who successfully removed a colloid cyst from the third ventricle through a posterior transcallosal approach. Despite their unfavourable locations, these tumours can be removed successfully by proper knowledge of anatomical landmarks and by choosing the appropriate approach. Methods. We performed a retrospective analysis of all patients (17 patients) who underwent surgery for anterior third ventricular masses between March 2018 to March 2020 in the Dr Ram Manohar Lohia Institute of Medical Science Lucknow, Uttar Pradesh. Results: The most common symptom in our cases was headache, which was present in all (100%) patients, nausea/vomiting in 7 (41%), history of recurrent episodes of drop attacks in 4 (23%), h/o seizure in 2 (11.7%), visual disturbance in 1 (5.4%), memory disturbance in 1 (5.4%) and urinary incontinence in 1 (5.4%) patient. 6 patients were operated with transcallosal-transforaminal approach, 1 patient was operated with transcallosal interforniceal approach, 3 patients were operated with transcortical-transforaminal approach, 1 patient was operated with subfrontal translamina terminalis approach, 1 patient was operated with transcallosal-transchoroidal approach, 5 patients were operated with endoscopically. Gross total excision was achieved in 15 (88%) patients while in 2 (11.7%) patients subtotal resection was done due to their adherence to choroid plexus and optic chiasm. The most common post-operative complication was endocrine dysfunction in the form of diabetes insipidus. Conclusions. Anterior Third ventricular tumours are mostly benign and best treatment modality is surgical resection. When we analyzed the results of various approaches, we found that despite their unfavourable location, the results were satisfactory for different tumours of different location in the anterior third ventricle, when treated with the carefully planned microsurgical or endoscopic approach with proper knowledge of anatomical landmarks.

Ablation for hepatocellular carcinoma: beyond the standard indications

Hepatocellular carcinoma (HCC), the most common primary liver neoplasia, represents the fifth most common malignant disease in men. Percutaneous ablation treatment is recommended among the treatments suggested for HCC patients in the very early/early stage. In the last decade, very important results in terms of survival benefits have been obtained with local ablative therapies, also outside the standard indications, thanks to many technical innovations. In particular, important results of ablation as a safe and effective technique have been obtained in the treatment of intermediate- or advanced-stage patients with HCC, and in the treatment of unfavourable tumour locations. Moreover, awareness is growing regarding the necessity of overcoming the rigidity of traditional guidelines in the treatment of HCC due to the complexity of patients with HCC, focusing on Precision Medicine. In this context, it is important to know the standard and non-standard indications of ablation in the treatment of HCC in order to offer the best therapeutic option tailored for each patient. The aim of this study was to analyse the possible clinical applications of ablative therapies for HCC patients, beyond the traditional indications recommended in the most widespread clinical practice guidelines for the management of HCC.

Cadastre of unfavorable locations for anthrax of animals in the Republic of Sakha (Yakutia)

The article presents the results of the study on unfavourable locations for animals’ anthrax registered in the Republic of Sakha (Yakutia) conducted from 2010 to 2018. The research materials were archival documents of the veterinary service of the Yakutsk region, including written reports from the fi rst veterinarians to the Governor of the region about outbreaks of anthrax among domestic animals and people, statistics on the incidence and mortality rate of anthrax in domestic animals from 1811 to 1993, and data from the census of the population and animals. This work was carried out to compile the cadastre of stationary unfavourable locations for anthrax. During the study period, 739 outbreaks of anthrax among domestic and wild animals in 29 administrative districts and 244 settlements were recorded on the territory of the Republic. Among them, there were 455 unfavourable locations that were not previously included in the Russian Cadastre. The information presented in the cadastre of unfavourable locations for animals’ anthrax includes the name of the settlement and farm (given the administrative and territorial changes of districts, settlements and farm names), the year of registration, the number of unfavourable locations and the animal species. As a basis for compiling this cadastral map, geographical maps of the administrative and territorial divisions of the districts were used. These maps show unfavourable locations with signs and use cartographic, statistical and other methods applied in epizootology and epidemiology. The study of stationary unfavourable locations on the territory of the Republic of Sakha (Yakutia) has gained particular importance in recent decades. This was facilitated by the intensive development of the country’s economy, accompanied by large-scale development of deposits of diamond, gold, oil, gas, and the construction of railways and Lena and Kolyma federal roads. The construction works take place in the areas including the ones adjacent to stationary unfavourable locations, which therefore requires an assessment of their epidemiological risk. The cadastre of unfavourable locations for animals’ anthrax will enable specialists of Rospotrebnadzor, veterinary and design institutions, employees of the Ministry of Emergencies, municipalities of districts and settlements to develop and implement a set of preventive measures in places unfavourable for anthrax.

A quest for sphincter-saving surgery in ultralow rectal tumours\u2014a single-centre cohort study

IntroductionDespite the progress in the treatment of colorectal cancer, there is still no optimal strategy for tumours located adjacent to the anal sphincter. This study aims to evaluate oncological and functional results of surgery for rectal cancer in unfavourable locations in proximity to anal sphincters.Materials and methodsPatients with rectal cancer, which was either initially infiltrating the anal sphincter or located in the close proximity of the sphincter, were included in the study. Patients were submitted to extralevator abdominoperineal resection (APR), intersphincteric resection, or transanal total mesorectal excision (TaTME). Primary outcomes were perioperative data: operative time, blood loss, complications, length of stay (LOS), and 30-day mortality. Secondary outcomes were pathological quality of the specimens and functional outcome 6 months after defunctioning ileostomy closure.ResultsAmong patients with cancer adjacent to the anal sphincter, 13 (25%) underwent APR, 14 (27%) patients were submitted to intersphincteric resection, and 25 (48%) patients were treated with the TaTME approach. Operative time was 240 (210–270 IQR) for APR, 212.5 (170–260 IQR) for intersphincteric resection, and 270 (240–330 IQR) for TaTME (p = 0.018). Perioperative morbidity was 31% for APR, 36% for intersphincteric resections, and 12% for the TaTME group (p = 0.181). Complete mesorectal excision was achieved in 92% of specimens in the TaTME group, 93% in intersphincteric resections, and 78% in the APR group (p = 0.72). Median circumferential resection margin in APR was 6 mm (4–7 IQR), in intersphincteric resections 7.5 mm (2.5–10 IQR), and in the TaTME group 4 mm (2.8–8 IQR). All patients after intersphincteric resections developed major low anterior resection syndrome (LARS). Four patients in the TaTME group developed minor LARS, and 21 had major LARS.ConclusionSphincter-saving rectal resections are a feasible alternative to APR with good clinical, pathological, and oncological outcomes. Intersphincteric resections and TaTME seem to be equal in terms of clinicopathological results. The functional outcome is yet to be investigated.Trial registrationThe study was retrospectively registered in Thai Clinical Trials Registry (23-07-2018, ID TCTR20180724001).

Surgical versus non-surgical approach in primary desmoid-type fibromatosis patients: A nationwide prospective cohort from the French Sarcoma Group

PurposeThe outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors to guide the treatment choice. MethodWe conducted a prospective study of 771 confirmed cases of DTF. We analysed event-free survival (EFS) based on the occurrence of relapse after surgery, progressive disease during the wait-and-see approach, or change in therapeutic strategy. Identification of prognostic factors was performed using classical methods (log-rank test and Cox model). ResultsOverall, the 2-year EFS was 56%; this value did not differ between patients undergoing an operation and those managed by the wait-and-see approach (53% versus 58%, p = 0.415). In univariate analysis, two prognostic factors significantly influenced the outcome: the nature of diagnostic sampling (p = 0.466) and primary location (p = 0.0001). The 2-year EFS was only 32% after open biopsy. The 2-year EFS was 66% for favourable locations (abdominal wall, intra-abdominal, breast, digestive viscera and lower limb) and 41% for unfavourable locations. Among patients with favourable locations, the 2-year EFS was similar in patients treated by both surgery (70%) and the wait-and-see approach (63%; p = 0.413). Among patients with unfavourable locations, the 2-year EFS was significantly enhanced in patients initially managed with the wait-and-see approach (52%) compared with those who underwent initial surgery (25%; p = 0.001). ConclusionThe location of DTF is a major prognostic factor for EFS. If these findings are confirmed by independent analysis, personalised management of DTF must consider this easily obtained parameter.

Mesenteric lipogranuloma mimicking malignancy at 18F-FDG PET/CT in a patient with colon cancer

The outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors to guide the treatment choice.We conducted a prospective study of 771 confirmed cases of DTF. We analysed event-free survival (EFS) based on the occurrence of relapse after surgery, progressive disease during the wait-and-see approach, or change in therapeutic strategy. Identification of prognostic factors was performed using classical methods (log-rank test and Cox model).Overall, the 2-year EFS was 56%; this value did not differ between patients undergoing an operation and those managed by the wait-and-see approach (53% versus 58%, p = 0.415). In univariate analysis, two prognostic factors significantly influenced the outcome: the nature of diagnostic sampling (p = 0.466) and primary location (p = 0.0001). The 2-year EFS was only 32% after open biopsy. The 2-year EFS was 66% for favourable locations (abdominal wall, intra-abdominal, breast, digestive viscera and lower limb) and 41% for unfavourable locations. Among patients with favourable locations, the 2-year EFS was similar in patients treated by both surgery (70%) and the wait-and-see approach (63%; p = 0.413). Among patients with unfavourable locations, the 2-year EFS was significantly enhanced in patients initially managed with the wait-and-see approach (52%) compared with those who underwent initial surgery (25%; p = 0.001).The location of DTF is a major prognostic factor for EFS. If these findings are confirmed by independent analysis, personalised management of DTF must consider this easily obtained parameter.

Estimation of Distribution Transformer Losses in Feeder Circuit

Losses of distribution transformers (DT) in a distribution system (DS) depend on mainly load. Actual measurement of these losses is in substation (SS) feeder circuit is not easy due to many inconveniences like difficulty in installation of meters, unfavourable locations and conditions. But as the DT losses are sizeable they need to be considered for overall loss calculations. In this paper, an approach is developed to estimate the DT losses in a feeder circuit. Losses of individual DTs are calculated and summed up to give the losses due to DT circuit. A sample case of a large power system is considered. The losses are calculated by the said approach. The overall DT circuit losses are 8.57% of the total import.

Application of Risk Assessment to Cogeneration Source Planning In Restructured Power System

Nigeria very recently experienced a restructuring in her power system setup. This was done with the intention of involving private investors in the generation and distribution expansion plans in tandem with the country's millennium development goals. A major focus of the current energy debate is how to meet the future demand for electricity while meeting up with the high operational efficiency required in a deregulated power industry. Energy conservation and pollution minimization are central to such desired optimal operation in this new power structure. Problem arises when these generating stations are situated in unfavourable locations leading to high losses. Building cogeneration plants is a very efficient way of achieving large generation capacity, while reducing energy wastage and environmental pollution. This work assesses the risks involved in locating and sizing of cogenerating plants using Monte Carlo technique applied in MATLAB simulation environment. Results obtained are used to determine the benefits accruing to the utility companies when these cogeneration plants are connected to the grid. This is because it forms a major point of consideration in the planning of the generation system, particularly in deregulated systems where profit maximization is a key to surviving the competition

Is There a Role for Neoadjuvant Targeted Therapy to Downsize Primary Tumors for Organ Sparing Strategies in Renal Cell Carcinoma?

With an increasing number of small renal masses being diagnosed organ-preserving treatment strategies such as nephron-sparing surgery (NSS) or radiofrequency and cryoablation are gaining importance. There is evidence that preserving renal function reduces the risk of death of any cause, cardiovascular events, and hospitalization. Some patients have unfavourable tumor locations or large tumors unsuitable for NSS or ablation which is a clinical problem especially in those with imperative indications to preserve renal function. These patients may benefit from downsizing primary tumors by targeted therapy. This paper provides an overview of the current evidence, safety, controversies, and ongoing trials.

Intrathecal liposomal cytarabine in children under 4 years with malignant brain tumors

Infants and very young children with malignant brain tumors usually have unfavourable locations and are not candidates for craniospinal irradiation. New therapeutic approaches must be attempted to improve poor survival rates. The primary goal of the present study was to report on the safety profile and toxicity of intrathecal administration of liposomal cytarabine in children <4 years with malignant brain tumors. This is the first study including this group of patients receiving intrathecal liposomal cytarabine. Nine patients with a median age of 26 months were eligible for the study. The diagnoses were ependymoma (3), peripheral neuroectodermic tumor (PNET) (2), meduloblastoma, atypical teratoid rhabdoid tumor (ATRT), cerebral lymphoma, and rhabdomyosarcoma with CNS invasion. Liposomal cytarabine at doses between 20 and 35 mg were administered by lumbar puncture. Dexamethasone was given for arachnoiditis prophylaxis. A total of 44 doses (median = 6) of liposomal cytarabine were administered. Neurological side effects possibly related to liposomal cytarabine were observed in five patients (55.6%). This incidence was higher than previously reported in children older than 3 years. Eight of the patients (89%) experienced an initial improvement of clinical symptoms after initiation treatment, confirmed by MRI. This study demonstrates the feasibility of using intrathecal liposomal cytarabine in children under 4 years of age with malignant brain tumors.

Brood conspicuousness and clutch viability in male‐caring assassin bugs (Rhinocoris tristis)

Abstract 1. Conspicuousness to mates can bring benefits to both males (increased mating success) and females (reduced search costs), but also brings costs (e.g. increased predation and parasitism). Assassin bugs, Rhinocoris tristis, lay egg clutches either on exposed stems or hidden under leaves. Males guard eggs against parasitoids. Guarding males are attractive to females who add subsequent clutches to the brood. This is an excellent opportunity to study the effects of conspicuousness on the fitness of males and females.2. Using viable eggs in a multi‐clutch brood as a correlate of fitness, the present study examined whether laying eggs on stems affected (1) female fitness, through exposure to parasitism and cannibalism, and (2) male fitness, through attracting further females.3. Stem broods were more parasitised. However, males on stems accumulated more mates and more eggs, a net benefit even accounting for parasitism. The eggs gained from being on a stem were cannibalised. By contrast, higher mortality on stems suggests that females should gain by ovipositing on leaves. To the extent that egg viability represents fitness, male and female interests may therefore differ. This suggests a potential for sexual conflict that may affect other species with male care.4. Despite higher costs, females actually initiated more broods, and subsequently added bigger clutches to broods, on stems than under leaves. This suggests either that viable eggs do not reflect fitness, or that females laid in unfavourable locations. The key is now to address lifetime fitness, since unmeasured factors may affect offspring viability post‐hatching, and to investigate who controls the location of oviposition in R. tristis.

A photometric pilot study on Sonneberg archival patrol plates

The light curves of 216 arbitrarly chosen field stars and of 23 known variables in the Aur/Tau/Ori region were derived (7. m 8 ≤ B ≤ 12. m 2) from scanned, blue-sensitive archival patrol plates, covering a total of 34 years (1961−1995). We achieved a photometric accuracy of 0.07 ... 0.12 mag in spite of rather unfavourable locations of most stars near the plate borders. 17 field stars turned out to be variables, most of them with time scales of 1000−8000 days in the form of slow waves with amplitudes between 0.1 and 0.3 mag, i.e. below the threshold of traditional variable searches on photographic plates. About 50% of these new long-term variables exhibit drifts indicating periodic or erratic variability at much longer time scales than covered here. For the 23 known variables we achieved improvements in their periods and amplitudes and detected long- term variations (drifts, waves) in about 50% of them. The above fraction of low-amplitude long-term variables among field stars implies that a total of about 45 000 new variables should be detectable in the Sonneberg patrol plate archive. They will represent a new, hitherto not investigated population of variable stars with a possibly significant impact on our understanding of the stellar interior and evolution.

Orbital exenteration in 95 cases of primary conjunctival malignant melanoma.

The role of orbital exenteration in the management of malignant melanoma of the conjunctiva has been underexplored. The outcome in 95 patients with this condition, who underwent exenteration as a primary treatment (n = 36) or after failure of other treatment (n = 59) for early to advanced stages of the disease, was evaluated. The majority of treated cases had multicentric melanomas sited at prognostically unfavourable locations. In the group of tumours with a maximum thickness of 1.0 mm no melanoma related mortality was noted. Melanomas thicker than 1.0 mm were associated with a mortality varying between 33% and 50%, independent of whether exenteration was performed as primary or secondary treatment. An especially poor outcome was noted for the group of caruncular melanomas despite exenteration. These findings indicate that total eradication of tumour should be performed at an early stage. For this purpose, a combination of debulking surgery and adjunctive cryotherapy or beta radiotherapy is more appropriate than orbital exenteration which causes disfigurement and blindness. Exenteration of the orbit should be reserved as a palliative procedure for advanced stages of neoplastic disease.

Prognostic factors in primary malignant melanoma of the conjunctiva: a clinicopathological study of 256 cases.

A series of 256 consecutive cases of invasive primary conjunctival malignant melanomas was examined to identify clinical and histopathological prognostic factors. The follow up period varied between 0.3 and 45.9 years (mean 9 years, median 6.3 years). The 5 year survival rate was estimated at 82.9%, the 10 year survival rate at 69.3%. Multiple regression analysis with the Cox proportional hazards model was used to assess sex, age, and a number of baseline features of conjunctival malignant melanoma as possible prognostic factors influencing melanoma related mortality. In assessing each potential prognostic factor, the effects of all other factors were taken into account in the modelling process. Tumours in unfavourable locations--that is, those involving the palpebral conjunctiva, fornices, plica, caruncle, and lid margins, were associated with 2.2 times higher mortality compared with (epi)bulbar melanomas. Patients with mixed cell type tumours had about three times higher mortality compared with those with pure spindle cell melanomas, and histological evidence of lymphatic invasion by tumour cells was also a prognostic feature, carrying a fourfold increase in the death rate. Multifocal tumours were associated with a fivefold increase in mortality among those with tumours in favourable (epi)bulbar locations, but were not prognostic in patients with melanomas in unfavourable sites. The death rate was significantly higher in those with initial tumour thickness of more than 4 mm, but only among patients with unfavourably located melanomas. Sex, age, and clinical origin of the tumour (primary acquired melanosis, pre-existing naevus, or de novo) were not useful prognostic indicators in this study.

On the causes of the inadequate protection afforded by Lightning Rods, in some cases, and the means of insuring their perfect competency: also, a refutation of the prevalent idea, that Metals are peculiarly attractive of Electricity

The outcome of desmoid-type fibromatosis (DTF) is unpredictable. Currently, a wait-and-see approach tends to replace large en bloc resection as the first therapeutic approach. Nevertheless, there are no validated factors to guide the treatment choice.We conducted a prospective study of 771 confirmed cases of DTF. We analysed event-free survival (EFS) based on the occurrence of relapse after surgery, progressive disease during the wait-and-see approach, or change in therapeutic strategy. Identification of prognostic factors was performed using classical methods (log-rank test and Cox model).Overall, the 2-year EFS was 56%; this value did not differ between patients undergoing an operation and those managed by the wait-and-see approach (53% versus 58%, p = 0.415). In univariate analysis, two prognostic factors significantly influenced the outcome: the nature of diagnostic sampling (p = 0.466) and primary location (p = 0.0001). The 2-year EFS was only 32% after open biopsy. The 2-year EFS was 66% for favourable locations (abdominal wall, intra-abdominal, breast, digestive viscera and lower limb) and 41% for unfavourable locations. Among patients with favourable locations, the 2-year EFS was similar in patients treated by both surgery (70%) and the wait-and-see approach (63%; p = 0.413). Among patients with unfavourable locations, the 2-year EFS was significantly enhanced in patients initially managed with the wait-and-see approach (52%) compared with those who underwent initial surgery (25%; p = 0.001).The location of DTF is a major prognostic factor for EFS. If these findings are confirmed by independent analysis, personalised management of DTF must consider this easily obtained parameter.