If the tumour has spread to a certain extent, an interdisciplinary meeting should be held to determine if it makes sense to perform chemotherapy before surgery. This therapy is carried out over three months and significantly improves the prognosis. If an unexpected advanced stage is diagnosed after surgical removal of the tumour, the possibility of an additional four months of chemotherapy should be discussed during the tumour board meeting.
In the case of tumour dissemination/metastasis, the prognosis is grave. A palliative (symptom-relieving, but not curative) treatment will be implemented.