A study suggests that it may be possible lower amputation rates by nearly 80% in patients with extremity sarcomas. Patients with advanced malignant cancer of the arms or legs have typically faced amputation of the afflicted limb as the only treatment option. Now, researchers are suggesting that a new technique that limits the application of chemotherapy to the cancerous region can preserve limbs in a high percentage of these patients.1
The researchers used regional chemotherapy with isolated limb perfusion (ILI) in 77 patients with treatment-resistant, locally advanced soft tissue sarcomas. They were able to salvage limbs in 77.9% of the cases. The study, which was conducted at the Moffitt Cancer Center in Tampa, Florida, suggested that isolated limb infusion is a safe and effective technique for patients with locally advanced soft tissue sarcoma.
The study looked at patients treated over a 22 year period (1994-2016) and is the largest one to date of limb preservation using ILI for sarcoma. In the study, 19 patients had 21 procedures for upper-extremity disease and 58 patients had 63 infusions for lower-extremity disease. The results varied significantly for the 2 groups. The overall three-month response rate to ILI was 58%, but it was only 37% for those with upper-extremity disease compared to 66% for lower-extremity disease.
Those who had upper-extremity sarcomas had a lower median overall survival than their lower-extremity counterparts, 27.9 months compared to 56.6 months. For the entire study population, the median overall survival was 44.3 months.
1. Mullinax JE, Kroon HM, Thompson JF, et al. Isolated Limb Infusion as a Limb Salvage Strategy for Locally Advanced Extremity Sarcoma. J Am Coll Surg. 2017 Feb 15. doi: 10.1016/j.jamcollsurg.2016.12.035 [Epub ahead of print]