Isolated limb perfusion with tumor necrosis factor and melphalan for non-resectable soft tissue sarcomas: long-term results on efficacy and limb salvage in a selected group of patients

Détails

ID Serval
serval:BIB_B92A352E8422
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Isolated limb perfusion with tumor necrosis factor and melphalan for non-resectable soft tissue sarcomas: long-term results on efficacy and limb salvage in a selected group of patients
Périodique
Jounal of Surgical Oncology
Auteur(s)
Cherix S., Speiser M., Matter M., Raffoul W., Liénard D., Theumann N., Mouhsine E., Mirimanoff R.O., Leyvraz S., Lejeune F.J., Leyvraz P.F.
ISSN
1096-9098
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
98
Numéro
3
Pages
148-155
Langue
anglais
Résumé
Background And Objectives:
Isolated limb perfusion with TNF-alpha and melphalan (TM-ILP) is a limb salvage therapy for non-resectable soft tissue sarcomas (STS) of the extremities. It is indicated for patients for whom amputation or debilitating surgery is the only alternative. It can be used either as an exclusive therapy (in palliation) or as a neo-adjuvant treatment, followed by marginal resection of tumor remnants with minimal functional impairment.
Methods:
Between February 1992 and March 2006, 57 TM-ILPs were performed on 51 patients with 88% high grade and 84% advanced stage tumors.
Results:
Mean follow-up is 38.9 months (4-159, median 22 months). Twenty-one percent patients had significant early complications, with 3 major re-operations, and 23% suffered long-lasting complications. Complete response was observed in 25%, partial response in 42%, stable disease in 14% and progressive disease in 14%. Resection of the tumor remnants was possible in 65%. A complementary treatment was necessary in 31%, mostly radiation therapy. A local recurrence was observed in 35%, after a mean of 20.3 months (2-78), and distant relapse was seen in 45%, after a mean of 13.4 months (5-196). Mean Disease-free survival was 14.9 months, and overall 5-year-survival 43.5%. Amputation rate at 5 years was 24%.
Conclusions:
TM-ILP is a conservative treatment with a high complications rate, but it can be successful even for the most severe STS of extremities. As a consequence the limb can be spared from amputation or debilitating surgery on the long term in about 75% of patients
Mots-clé
Adult , Aged, Aged, 80 and over , Antineoplastic Agents, Alkylating/administration & dosage, Antineoplastic Agents, Alkylating/therapeutic use, Chemotherapy, Cancer, Regional Perfusion , Female , Humans , Limb Salvage , Male , Melphalan/administration & dosage, Melphalan/therapeutic use , Middle Aged , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/drug therapy , Remission Induction , Sarcoma/drug therapy, Sarcoma/surgery , Soft Tissue Neoplasms/drug therapy , Soft Tissue Neoplasms/surgery , Treatment Outcome , Tumor Necrosis Factor-alpha/administration & dosage , Tumor Necrosis Factor-alpha/therapeutic use
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/02/2009 16:17
Dernière modification de la notice
20/08/2019 16:27
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