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Long-term outcomes of isolated limb perfusion with hyperthermia in patients with soft tissue sarcomas


In case of locally advanced soft tissue sarcomas of the extremities (STS), the large size of which does not allow resection with preservation of the limb, isolated regional perfusion (IRP) of the limb is considered as one of the effective treatment options.

Aim. To evaluate the long-term outcomes of IRP with melphalan under conditions of hyperthermia for treatment of locally advanced STS of the extremities.

Materials and methods. We conducted a prospective cohort clinical study that included 42 patients with STS of the extremities. All patients underwent IRP with melphalan, in one case – in combination with tumor necrosis factor alpha. Additional lymph node dissection was performed in 8 cases (19%). The 5-year overall survival was estimated by the Kaplan-Meier method.

Results. The median age of the patients was 50 years (from 24 to 80 years), women predominated – 32 (76%). STS of the upper limb was diagnosed in 14 patients (33%), of the lower limb in 28 (67%). G3 grade was verified in 34 (81%) patients, in the rest – G2. Most patients had a recurrent tumor – in 34 (81%) cases. All patients received previous treatment: surgery in combination with chemotherapy and / or radiation therapy – 36 (86%), chemotherapy alone – 2 (5%), surgery alone – 4 (9%) patients. Within 5 years, tumor recurrence developed in 20 (48%) patients, amputation was performed in 10 (24%) patients, distant metastases were diagnosed in 4 (10%) patients. The mean time to relapse after IPC was 9.3 ± 3.5 months. Overall survival at 1, 2, 3, 4, and 5 years was 98%, 88%, 86%, 74%, and 67%, respectively.

Conclusion. IRP under conditions of hyperthermia with melphalan is an effective method for the treatment of STS of the extremities: the overall 5-year survival rate is 67% with a low rate of amputations and metastasis.

About the Authors

T. K. Kharatishvili
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Teimuraz K. Kharatishvili, Dr. of Sci. (Medicine), Professor, Leading researcher, Department of bone, soft tissue and skin tumors

24, Kashirskoye Highway, Moscow, 115478

N. S. Petrochenko
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Nikolay S. Petrochenko, Cand. of Sci. (Medicine), Researcher, Department of bone, soft tissue and skin tumors

24, Kashirskoye Highway, Moscow, 115478

E. I. Gribkova
Sechenov First Moscow State Medical University (Sechenov University
Russian Federation

Elizaveta I. Gribkova, postgraduate student, Department of Oncology

8/2, Trubetskaya str., Moscow, 119991, Russia

+7 (960) 536-63-67

Yu.  V. Buidenok
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Yuri V. Buidenok, Dr. of Sci. (Medicine), Professor, Leading researcher, Department of Interventional Radiology

24, Kashirskoye Highway, Moscow, 115478

S. M. Kaspshik
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Stepan M. Kaspshik, Radiologist, Department of Radionuclide Diagnostics No. 1

24, Kashirskoye Highway, Moscow, 115478

M. D. Aliyev
P. Herzen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre
Russian Federation

Mamed D. Aliyev, Dr. of Sci. (Medicine), Professor, Academician of the RAS, Advisor to the General Director

3, 2nd Botkinsky drive, Moscow, 125284


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