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Multifocal soft tissue sarcoma: Limb salvage following hyperthermic isolated limb perfusion with high‐dose tumor necrosis factor and melphalan
Author(s) -
LevChelouche Dina,
AbuAbeid Subhi,
Kollander Yehuda,
Meller Isaac,
Isakov Josephine,
Merimsky Ofer,
Klausner Joseph M.,
Gutman Mordechai
Publication year - 1999
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199903)70:3<185::aid-jso8>3.0.co;2-#
Subject(s) - medicine , melphalan , soft tissue , soft tissue sarcoma , limb perfusion , sarcoma , perfusion , necrosis , radiology , upper limb , chemotherapy , surgery , pathology
Background and Objectives The prognosis for recurrent multifocal limb soft tissue sarcoma (STS) is dismal due to systemic spread. However, many of these patients undergo amputation due to ineffective local control. The purpose of the present study was to determine whether isolated limb perfusion (ILP) with tumor necrosis factor (TNF) and melphalan permits limb salvage and palliation for such patients. Methods Of 53 STS patients treated with hyperthermic ILP with TNF (3–4 mg) and melphalan (1–1.5 mg/kg), 13 (25%) had multifocal STS and were candidates for amputation. Results The overall response rate was 92% (12/13) with 38% complete response and 54% partial response. Two patients died during the early postoperative period. Limb salvage was achieved in 85% of patients. One patient (8%) had only stable disease and underwent amputation. Local recurrence occurred in 38% but did not result in amputation. Conclusions Although the number of patients in this study is too small to allow definitive conclusions, it seems that ILP/TNF offer limb salvage and palliation for recurrent multifocal STS patients. J. Surg. Oncol. 1999;70:185–189. © 1999 Wiley‐Liss, Inc.