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01-02-2007

Advanced Extremity Soft Tissue Sarcoma: Prognostic Effect of Isolated Limb Perfusion in a Series of 88 Patients Treated at a Single Institution

Authors: Elisabetta Pennacchioli, MD, Marcello Deraco, MD, Luigi Mariani, MD, Marco Fiore, MD, Chiara Mussi, MD, Paola Collini, MD, Patrizia Olmi, MD, Paolo G. Casali, MD, Mario Santinami, MD, Alessandro Gronchi, MD

Published in: Annals of Surgical Oncology | Issue 2/2007

ABSTRACT

Purpose

To explore the prognostic impact of isolated limb perfusion (ILP) in locally advanced extremity soft tissue sarcomas (ESTS).

Methods

From August 1982 to April 2005, 1,119 patients affected by ESTS (girdle excluded) were observed and treated at our institution. Eighty-eight (7.9%) were judged non-resectable or locally advanced and underwent ILP. Thirty-seven patients received antiblastic alone (non-TNF-ILP) while 51 had anti-blastic + recombinant-tumor necrosis factor alpha (TNF-ILP). Local disease-free survival (LDFS) was calculated by the Kaplan–Maier method and was reported separately in the two subgroups.

Results

Limb salvage was achieved in 83% (73/88) of the patients. The observed overall (complete + partial) response rate was 59%. In the TNF-ILP group a complete response (CR) was achieved in 21 (41%) patients, while in the non-TNF ILP group a CR was obtained in seven (19%) cases (P < 0.05). Patients with in-transit metastases (epithelioid sarcomas and clear cell sarcomas) had a significantly worse long-term outcome (LDFS at 5 years was 40.9 vs 67.3%, P < 0.05). A trend towards a better LDFS at 5 years could be observed in the patients receiving TNF (63.6 vs 57.1%) and post-operative radiation therapy (RT) (79.3 vs 55.4%).

Conclusions

Isolated limb perfusion is an active treatment. By adding TNF a better local control seems to be obtained, possibly due to a higher rate of CR. It should therefore be considered as a valid option for patients affected by limb-threatening STS, save for in-transit metastases from epithelioid and clear cell sarcoma. Post-operative RT should always be considered.

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Title: Advanced Extremity Soft Tissue Sarcoma: Prognostic Effect of Isolated Limb Perfusion in a Series of 88 Patients Treated at a Single Institution
Authors: Elisabetta Pennacchioli, MD
Marcello Deraco, MD
Luigi Mariani, MD
Marco Fiore, MD
Chiara Mussi, MD
Paola Collini, MD
Patrizia Olmi, MD
Paolo G. Casali, MD
Mario Santinami, MD
Alessandro Gronchi, MD
Publication date: 01-02-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 2/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9251-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Advanced Extremity Soft Tissue Sarcoma: Prognostic Effect of Isolated Limb Perfusion in a Series of 88 Patients Treated at a Single Institution

ABSTRACT

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ABSTRACT

Purpose

Methods

Results

Conclusions

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