1504P - Isolated Limb Perfusion in Locally-Advanced Limb Soft Tissue Sarcomas: Retrospective Study of A 23-Year Experience

Abstract

ABSTRACT Background Hyperthermic isolated limb perfusion (HILP) is a cytoreductive treatment to avoid amputation in limb soft tissue sarcomas (LSTS). HILP drug schedule has been modified to balance treatment activity and toxicity. Methods From 1988 to 2011, 117 patients with unresectable primary or recurrent LSTS underwent HILP. Tumor characteristics, HILP parameters and drugs (doxorubicin; doxorubicin plus TNFa; TNFa plus L-PAM), postoperative plasma myoglobin, tumor response, systemic chemotherapy (CT), site of recurrence and outcome were analyzed. Results The 3 treatment groups were homogeneous for clinical pathological features. The tumor response (necrosis in resected specimen) was comparable (P = .473) (Table) and was correlated with myoglobin (P Conclusions Doxorubicin, doxorubicin + TNFa and TNFa + L-PAM schedules are equally active, with comparable toxicity profiles. Upper LSTS and poor post-HILP necrosis were related with higher amputation rates. Despite preserving limb function, 40% of HILP patients develop a systemic recurrence, particularly when achieving lower responses. Lung relapses lung have a relatively better prognosis. Drug schedule Tumor necrosis, median % (range) Locoregional toxicity according to Wieberdink n° of pts (%) 1- 2 3 4 5 DOXO n = 47 54 (7-91) 38 (80.9) 8 (17.0) 1 (2.1) 0 TNFa + DOXO n = 30 64 (10-100) 24 (80.0) 4 (13.4) 1 (3.3) 1 (3.3) TNFa + L-PAM n = 40 57 (4-91) 37 (92.5) 1 (2.5) 2 (5.0) 0 Disclosure All authors have declared no conflicts of interest.