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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2012

01-06-2012 | Bone and Soft Tissue Sarcomas

Long-Term Outcome of Isolated Limb Perfusion in Advanced Soft Tissue Sarcoma of the Extremity

Authors: R. Olofsson, MD, P. Bergh, MD, PhD, Ö. Berlin, MD, PhD, K. Engström, MD, PhD, B. Gunterberg, MD, PhD, M. Hansson, MD, PhD, P. Lindnér, MD, PhD, J. Mattsson, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2012

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Abstract

Background

Isolated limb perfusion with tumor necrosis factor alpha and melphalan (TM-ILP) has proven to be a successful option in treating advanced soft tissue sarcomas (STS), where amputation otherwise is needed to achieve safe surgical margins.

Methods

From 2000 to 2009, 54 patients with locally advanced STS, who all were candidates for amputation, were treated with totally 57 TM-ILP procedures and then followed prospectively. The median follow-up time was 30 months. Median tumor size was 10 cm, and 94% of the patients had high-grade tumors.

Results

The clinical overall response after TM-ILP was 71% (including 21% CR), and 60% of the patients underwent resection of the tumor remnant after a median of 2 months. The histopathologic response rate in the resected specimens was 76%. Local recurrence/progress occurred in 37% of the patients after a median of 7 months. Thirteen patients finally underwent amputation after a median of 11 months, giving a long-term limb salvage of 76%.

Conclusions

TM-ILP of advanced soft tissue sarcoma of the extremities makes limb-sparing surgery possible in a high proportion of patients.
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Metadata
Title
Long-Term Outcome of Isolated Limb Perfusion in Advanced Soft Tissue Sarcoma of the Extremity
Authors
R. Olofsson, MD
P. Bergh, MD, PhD
Ö. Berlin, MD, PhD
K. Engström, MD, PhD
B. Gunterberg, MD, PhD
M. Hansson, MD, PhD
P. Lindnér, MD, PhD
J. Mattsson, MD, PhD
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-2196-z

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