Variation in response rates to isolated limb perfusion in different soft-tissue tumour subtypes: an international multi-centre study
- Author(s)
- Reijers, SJM; Davies, E; Grunhagen, DJ; Fiore, M; Honore, C; Rastrelli, M; Vassos, N; Podleska, LE; Niethard, M; Jakob, J; Perhavec, A; Duarte, C; Gonzalez, F; Deroose, JP; Stas, M; Boecxstaens, V; Schrage, Y; Snow, H; Algarra, SM; Said, HM; Garcia-Ortega, DY; Martin, K; Mattsson, J; Djafarrian, R; Di Lorenzo, G; Colombo, C; Gronchi, A; Matter, M; Verhoef, C; Olofsson Bagge, R; Hohenberger, P; Hayes, AJ; van Houdt, WJ;
- Journal Title
- European Journal of Cancer
- Publication Type
- Research article
- Abstract
- OBJECTIVE: The aim of this study was to investigate the response rates of different extremity soft-tissue sarcoma subtypes (eSTS) after isolated limb perfusion (ILP), based on an international multi-centre study. MATERIALS AND METHODS: The retrospective cohort comprised eSTS patients from 17 specialised ILP centres that underwent melphalan-based ILP, with or without recombinant human tumour necrosis factor (rhTNFalpha) (TM-ILP and M-ILP, respectively). Response was measured on imaging (magnetic resonance imaging) and/or clinical response, for which M-ILPs were excluded. RESULTS: A total of 1109 eSTS patients were included. The three most common histological subtypes were undifferentiated pleomorphic sarcoma (17%, n = 184), synovial sarcoma (16%, n = 175) and myxofibrosarcoma (8%, n = 87). rhTNFalpha was used in 93% (TM-ILP) and resulted in a significantly better overall response rate (ORR, p = 0.031) and complete responses (CR, p < 0.001) in comparison to M-ILP, without significant differences among histological subgroups. The ORR of TM-ILP was 68%, including 17% CR. Also, 80% showed progressive disease. Significantly higher response rates were shown for Kaposi sarcoma (KS) with 42% CR and 96% ORR (both p < 0.001), and significantly higher CR rates for angiosarcoma (AS, 45%, p < 0.001) and clear cell sarcoma (CCS, 31%, p = 0.049). ILP was followed by resection </= 6 months in 80% of the patients. The overall limb salvage rate was 88%, without significant differences among histological subgroups, but was significantly higher for ILP responders compared to non-responders (93% versus 76%, p < 0.001). CONCLUSION: ILP resulted in high response and LRS among all eSTS subtypes, however, with significant differences between subtypes with most promising results for KS, AS and CCS.
- Publisher
- Elsevier
- Keywords
- Adult; Humans; Retrospective Studies; Chemotherapy, Cancer, Regional Perfusion/methods; *Sarcoma/pathology; Melphalan/therapeutic use; Extremities/pathology; *Soft Tissue Neoplasms/pathology; *Sarcoma, Kaposi; Perfusion; Tumor Necrosis Factor-alpha; Antineoplastic Agents, Alkylating/therapeutic use; Ilp; Isolated limb perfusion; Response evaluation; Soft-tissue sarcoma
- Department(s)
- Surgical Oncology
- PubMed ID
- 37453241
- Publisher's Version
- https://doi.org/10.1016/j.ejca.2023.112949
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2023-10-12 05:13:34
Last Modified: 2024-07-16 04:38:04