Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
J Surg Oncol. 2014 Jun;109(8):786-90. doi: 10.1002/jso.23591. Epub 2014 Mar 12.
Isolated limb perfusion (ILP) is an effective limb salvage strategy in patients with advanced soft tissue sarcoma (STS) where surgery alone would result in significant functional morbidity or mandate an amputation. Most previous reports of patients undergoing ILP focus on limb salvage rates rather than local and distant relapse rates. Here, we report the oncological outcome of sarcoma patients treated by ILP and surgery.
Data were retrieved from prospective ILP databases from two ILP centers following similar ILP techniques and surgical approaches. Only patients with primary, intermediate, or high grade non-metastatic STS were included.
The cohort comprised 90 patients. Median follow-up was 39 months (range 3-165 months). Median tumor size was 11 cm (range 5-34). Twenty of 90 (22%) patients underwent prior debulking surgery outside the centers. Twenty-nine of 90 (32%) had postoperative irradiation. Four of 90 underwent amputation either related to local recurrence or irresectability, 4 of 90 underwent amputation for treatment-related complications. Fifteen of 83 (18%) patients had local recurrences after ILP and limb sparing surgery, 39 of 90 (43%) developed metastatic disease. Twenty-two of 90 (24%) died of disease.
Preoperative ILP and tumor resection resulted in good local control in a cohort of high-risk STS patients.
孤立肢体灌注（ILP）是一种有效的肢体保存策略，适用于单独手术会导致显著功能障碍或需要截肢的晚期软组织肉瘤（STS）患者。大多数接受 ILP 治疗的患者的报告重点是保肢率，而不是局部和远处复发率。在这里，我们报告了接受 ILP 和手术治疗的肉瘤患者的肿瘤学结果。
从两个 ILP 中心的前瞻性 ILP 数据库中检索数据，这些中心采用类似的 ILP 技术和手术方法。仅纳入原发性、中间型或高级别非转移性 STS 的患者。
该队列包括 90 名患者。中位随访时间为 39 个月（范围 3-165 个月）。中位肿瘤大小为 11cm（范围 5-34）。20/90（22%）名患者在中心外接受过先前的减瘤手术。29/90（32%）名患者术后接受了放疗。4/90 名患者因局部复发或无法切除而行截肢，4/90 名患者因治疗相关并发症而行截肢。15/83（18%）名接受 ILP 和保肢手术后的患者出现局部复发，90 名中有 39 名（43%）发生转移性疾病。22/90（24%）名患者因疾病死亡。
在高危 STS 患者队列中，术前 ILP 和肿瘤切除导致良好的局部控制。
