Isolated hyperthermic limb perfusion for soft tissue sarcoma

Background By combining different treatment modalities, function sparing resection of soft tissue sarcoma of the extremities has become possible for the majority of patients. To evaluate the role of isolated hyperthermic limb perfusion in this concept, the patients treated with this method in our institution were reviewed. Methods From January 1982 to December 1991 18 patients with extremity soft tissue sarcoma were treated by isolated hyperthermic limb perfusion. 41% of the patients presented with local recurrence, 67% with high grade malignancy and 61% after incomplete tumor resection. If present, residual tumors were resected several weeks after perfusion. Results The 5-year survival rate is 94% (mean follow-up 30 months). 38.6% of the patients developed local tumor recurrence, but limb sparing treatment had been carried out only after refusal of amputation in 4 of the 7 patients with local failure. Complications of therapy were moderate. Systemic toxicity was not observed. Conclusions We conclude that isolation perfusion is a valuable addition to combined modality treatment of soft tissue sarcomas of the extremities. With the aid of this method limb salvage can be achieved for the majority of patients.