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Isolated Limb Perfusion (isolated + limb_perfusion)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Isolated limb infusion: A review

JOURNAL OF SURGICAL ONCOLOGY, Issue 2 2009
Hidde M. Kroon MD
Abstract Isolated limb perfusion is the preferred treatment option for locally advanced melanoma and sarcoma confined to a limb. This treatment results in high response rates with a satisfying duration of response in both tumours. A drawback of isolated limb perfusion, however, is the invasive and complex character of the procedure. Isolated limb infusion has been designed as a minimally invasive alternative to isolated limb perfusion. Treatment results of this simple technique, reported by various centres worldwide, show comparable response rates for melanoma and sarcoma. Therefore isolated limb infusion may replace isolated limb perfusion in the future as the preferred treatment option for these locally advanced limb tumours. J. Surg. Oncol. 2009;100:169,177. © 2009 Wiley-Liss, Inc. [source]

Outcome and prognostic factor analysis of 217 consecutive isolated limb perfusions with tumor necrosis factor-, and melphalan for limb-threatening soft tissue sarcoma

CANCER, Issue 8 2006
Dirk J. Grunhagen M.D.
Abstract BACKGROUND Extensive and mutilating surgery is often required for locally advanced soft tissue sarcoma (STS) of the limb. As it has become apparent that amputation for STS does not improve survival rates, the interest in limb-preserving approaches has increased. Isolated limb perfusion (ILP) with tumor necrosis factor-, (TNF) and melphalan is successful in providing local tumor control and enables limb-preserving surgery in a majority of cases. A mature, large, single-institution experience with 217 consecutive ILPs for STS of the extremity is reported. METHODS At a prospectively maintained database at a tertiary referral center, 217 ILPs were performed from July 1991 to July 2003 in 197 patients with locally advanced STS of the extremity. ILPs were performed at mild hyperthermic conditions with 1,4 mg of TNF and 10,13 mg/L limb-volume melphalan (M) for leg and arm perfusions, respectively. RESULTS The overall response rate was 75%. Limb salvage was achieved in 87% of the perfused limbs. Median survival post-ILP was 57 months and prognostic factors for survival were Trojani grade of the tumor and ILP for single versus multiple STS. The procedure could be performed safely, with a perioperative mortality of 0.5% in all patients with no age limit (median age, 54 yrs; range, 12,91). Systemic and locoregional toxicity were modest and easily manageable. CONCLUSION TNF+M-based ILP can provide limb salvage in a significant percentage of patients with locally advanced STS and has therefore gained a permanent place in the multimodality treatment of STS. Cancer 2006. © 2006 American Cancer Society. [source]

Isolated limb infusion: A review

JOURNAL OF SURGICAL ONCOLOGY, Issue 2 2009
Hidde M. Kroon MD
Abstract Isolated limb perfusion is the preferred treatment option for locally advanced melanoma and sarcoma confined to a limb. This treatment results in high response rates with a satisfying duration of response in both tumours. A drawback of isolated limb perfusion, however, is the invasive and complex character of the procedure. Isolated limb infusion has been designed as a minimally invasive alternative to isolated limb perfusion. Treatment results of this simple technique, reported by various centres worldwide, show comparable response rates for melanoma and sarcoma. Therefore isolated limb infusion may replace isolated limb perfusion in the future as the preferred treatment option for these locally advanced limb tumours. J. Surg. Oncol. 2009;100:169,177. © 2009 Wiley-Liss, Inc. [source]

Outcome and prognostic factor analysis of 217 consecutive isolated limb perfusions with tumor necrosis factor-, and melphalan for limb-threatening soft tissue sarcoma

CANCER, Issue 8 2006
Dirk J. Grunhagen M.D.
Abstract BACKGROUND Extensive and mutilating surgery is often required for locally advanced soft tissue sarcoma (STS) of the limb. As it has become apparent that amputation for STS does not improve survival rates, the interest in limb-preserving approaches has increased. Isolated limb perfusion (ILP) with tumor necrosis factor-, (TNF) and melphalan is successful in providing local tumor control and enables limb-preserving surgery in a majority of cases. A mature, large, single-institution experience with 217 consecutive ILPs for STS of the extremity is reported. METHODS At a prospectively maintained database at a tertiary referral center, 217 ILPs were performed from July 1991 to July 2003 in 197 patients with locally advanced STS of the extremity. ILPs were performed at mild hyperthermic conditions with 1,4 mg of TNF and 10,13 mg/L limb-volume melphalan (M) for leg and arm perfusions, respectively. RESULTS The overall response rate was 75%. Limb salvage was achieved in 87% of the perfused limbs. Median survival post-ILP was 57 months and prognostic factors for survival were Trojani grade of the tumor and ILP for single versus multiple STS. The procedure could be performed safely, with a perioperative mortality of 0.5% in all patients with no age limit (median age, 54 yrs; range, 12,91). Systemic and locoregional toxicity were modest and easily manageable. CONCLUSION TNF+M-based ILP can provide limb salvage in a significant percentage of patients with locally advanced STS and has therefore gained a permanent place in the multimodality treatment of STS. Cancer 2006. © 2006 American Cancer Society. [source]