Isolated limb perfusion in the management of locally advanced soft tissue sarcoma: a single center experience with long-term follow-up

Abstract

Background Hyperthermic isolated limb perfusion (HILP) is an effective neoadjuvant treatment to avoid amputation in selected patients with locally-advanced extremity soft tissue sarcomas (STS). Patients and Methods This retrospective study shows single-centre experience with HILP in patients with unresectable STS, candidates for amputation, treated at the University Hospital and at Veneto Institute of Oncology of Padua (Italy) between February 1989 and September 2013. Surgery was performed at least 6-8 weeks after HILP; before surgery, a magnetic resonance imaging (MRI) was used to evaluate tumor shrinkage and response as well as the structures (e.g. vessels, nerves) around the tumor. Results A total of 117 patients were included; 55 patients (47.0%) achieved a pathological complete response and 35 patients (29.9%) a pathological partial response; there was no difference in response based on tumor presentation (primary vs local relapse; p=0.094). The overall limb sparing rate was 77.8% (91/117 patients). Conclusions Our experience confirms that HILP is an effective treatment for non-resectable primary, recurrent or metastatic advanced limb STS that is associated with a high rate of limb sparing and durable local disease control.