Variation in response rates to isolated limb perfusion in different soft-tissue tumour subtypes: an international multi-centre study

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 spe...

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Main Authors: Reijers, Sophie (Author) , Davies, Emma (Author) , Grünhagen, Dirk J. (Author) , Fiore, Marco (Author) , Honore, Charles (Author) , Rastrelli, Marco (Author) , Vassos, Nikolaos (Author) , Podleska, Lars E. (Author) , Niethard, Maya (Author) , Jakob, Jens (Author) , Perhavec, Andraz (Author) , Duarte, Carlos (Author) , González, Felipe (Author) , Deroose, Jan P. (Author) , Stas, Marguerite (Author) , Boecxstaens, Veerle (Author) , Schrage, Yvonne (Author) , Snow, Hayden (Author) , Algarra, Salvador Martín (Author) , Said, Hector Martinez (Author) , Garcia-Ortega, Dorian Yarih (Author) , Martin, Karla (Author) , Mattsson, Jan (Author) , Djafarrian, Reza (Author) , Di Lorenzo, Giorgia (Author) , Colombo, Chiara (Author) , Gronchi, Alessandro (Author) , Matter, Maurice (Author) , Verhoef, Cornelis (Author) , Olofsson Bagge, Roger (Author) , Hohenberger, Peter (Author) , Hayes, Andrew J. (Author) , van Houdt, Winan J. (Author)
Format: Article (Journal)
Language:English
Published: September 2023
In: European journal of cancer
Year: 2023, Volume: 190, Pages: 1-9
ISSN:1879-0852
DOI:10.1016/j.ejca.2023.112949
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ejca.2023.112949
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0959804923003015
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Author Notes:Sophie J.M. Reijers, Emma Davies, Dirk J. Grünhagen, Marco Fiore, Charles Honore, Marco Rastrelli, Nikolaos Vassos, Lars E. Podleska, Maya Niethard, Jens Jakob, Andraz Perhavec, Carlos Duarte, Felipe González, Jan P. Deroose, Marguerite Stas, Veerle Boecxstaens, Yvonne Schrage, Hayden Snow, Salvador Martín Algarra, Hector Martinez Said, Dorian Yarih Garcia-Ortega, Karla Martin, Jan Mattsson, Reza Djafarrian, Giorgia Di Lorenzo, Chiara Colombo, Alessandro Gronchi, Maurice Matter, Cornelis Verhoef, Roger Olofsson Bagge, Peter Hohenberger, Andrew J. Hayes, Winan J. van Houdt

MARC

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520 |a 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 (rhTNFα) (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). rhTNFα 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. 
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