UNLABELLED: This paper reports a single-institution experience with the use of isolated limb infusion for limb salvage in locally advanced, unresectable, recurrent limb threatening soft tissue sarcomas. BACKGROUND: Locally advanced, limb threatening soft tissue sarcomas (STS) pose a significant treatment challenge. We report our experience using isolated limb infusion (ILI) in patients with unresectable extremity STS. METHODS: A total of 22 patients with extremity STS underwent 26 ILIs with melphalan and dactinomycin. Patient characteristics, intra-operative parameters and toxicity were recorded. Outcome measures included limb-salvage and in-field response rates. RESULTS: Of the 19 lower and 7 upper extremity ILIs, Wieberdink grade III toxicity or less was observed in all. Median followup was 11 months. A total of 17 patients were evaluable at 3 months post-ILI with an overall response rate of 42%. Four (24%) had complete response (CR), three (18%) partial response (PR), three (18%) stable disease (SD) and seven (41%) progressive disease (PD). Twelve of 17 (71%) underwent successful limb preservation at a median of 9 months post-ILI. Two (12%) were downstaged to resectable disease and remain showing no evidence of disease (NED) after surgery at 30 and 22 months post-ILI. CONCLUSIONS: ILI is an attractive modality that provides regional disease control and limb preservation in patients with limb threatening sarcoma. Although short-term results appear encouraging, long-term follow-up is needed to fully assess the role of ILI in unresectable extremity STS.
UNLABELLED: This paper reports a single-institution experience with the use of isolated limb infusion for limb salvage in locally advanced, unresectable, recurrent limb threatening soft tissue sarcomas. BACKGROUND: Locally advanced, limb threatening soft tissue sarcomas (STS) pose a significant treatment challenge. We report our experience using isolated limb infusion (ILI) in patients with unresectable extremity STS. METHODS: A total of 22 patients with extremity STS underwent 26 ILIs with melphalan and dactinomycin. Patient characteristics, intra-operative parameters and toxicity were recorded. Outcome measures included limb-salvage and in-field response rates. RESULTS: Of the 19 lower and 7 upper extremity ILIs, Wieberdink grade III toxicity or less was observed in all. Median followup was 11 months. A total of 17 patients were evaluable at 3 months post-ILI with an overall response rate of 42%. Four (24%) had complete response (CR), three (18%) partial response (PR), three (18%) stable disease (SD) and seven (41%) progressive disease (PD). Twelve of 17 (71%) underwent successful limb preservation at a median of 9 months post-ILI. Two (12%) were downstaged to resectable disease and remain showing no evidence of disease (NED) after surgery at 30 and 22 months post-ILI. CONCLUSIONS: ILI is an attractive modality that provides regional disease control and limb preservation in patients with limb threatening sarcoma. Although short-term results appear encouraging, long-term follow-up is needed to fully assess the role of ILI in unresectable extremity STS.
Authors: S Bonvalot; A Laplanche; F Lejeune; E Stoeckle; C Le Péchoux; D Vanel; P Terrier; J Lumbroso; M Ricard; G Antoni; A Cavalcanti; C Robert; N Lassau; J Y Blay; A Le Cesne Journal: Ann Oncol Date: 2005-06-01 Impact factor: 32.976
Authors: Mohamed A F Hegazy; Sherif Z Kotb; Hanem Sakr; Ebrahim El Dosoky; Talal Amer; Refaat A F Hegazi; Omar Farouk Journal: Ann Surg Oncol Date: 2006-11-09 Impact factor: 5.344
Authors: Sylvie Bonvalot; Françoise Rimareix; Sylvain Causeret; Cécile Le Péchoux; Bérénice Boulet; Philippe Terrier; Axel Le Cesne; Jane Muret Journal: Ann Surg Oncol Date: 2009-10-15 Impact factor: 5.344
Authors: Georgia M Beasley; Abigail Caudle; Rebecca P Petersen; Nicole S McMahon; James Padussis; Paul J Mosca; Jonathan S Zager; Steven N Hochwald; Stephen R Grobmyer; Keith A Delman; Robert H Andtbacka; R Dirk Noyes; John M Kane; Hilliard Seigler; Scott K Pruitt; Merrick I Ross; Douglas S Tyler Journal: J Am Coll Surg Date: 2009-03-26 Impact factor: 6.113
Authors: Marc D Moncrieff; Hidde M Kroon; Peter C Kam; Paul D Stalley; Richard A Scolyer; John F Thompson Journal: Ann Surg Oncol Date: 2008-07-22 Impact factor: 5.344
Authors: Alfredo A Santillan; Keith A Delman; Georgia M Beasley; Paul J Mosca; Steven N Hochwald; Stephen R Grobmyer; Robert H Andtbacka; R Dirk Noyes; John M Kane; Merrick I Ross; Douglas S Tyler; Jonathan S Zager Journal: Ann Surg Oncol Date: 2009-06-19 Impact factor: 5.344