TY - JOUR
T1 - Variation in response rates to isolated limb perfusion in different soft-tissue tumour subtypes
T2 - an international multi-centre study
AU - Reijers, Sophie J.M.
AU - Davies, Emma
AU - Grünhagen, Dirk J.
AU - Fiore, Marco
AU - Honore, Charles
AU - Rastrelli, Marco
AU - Vassos, Nikolaos
AU - Podleska, Lars E.
AU - Niethard, Maya
AU - Jakob, Jens
AU - Perhavec, Andraz
AU - Duarte, Carlos
AU - González, Felipe
AU - Deroose, Jan P.
AU - Stas, Marguerite
AU - Boecxstaens, Veerle
AU - Schrage, Yvonne
AU - Snow, Hayden
AU - Algarra, Salvador Martín
AU - Said, Hector Martinez
AU - Ortega, Dorian Yarih Garcia
AU - Martin, Karla
AU - Mattsson, Jan
AU - Djafarrian, Reza
AU - Di Lorenzo, Giorgia
AU - Colombo, Chiara
AU - Gronchi, Alessandro
AU - Matter, Maurice
AU - Verhoef, Cornelis
AU - Bagge, Roger Olofsson
AU - Hohenberger, Peter
AU - Hayes, Andrew J.
AU - van Houdt, Winan J.
N1 - Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/9/1
Y1 - 2023/9/1
N2 - 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.
AB - 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.
KW - ILP
KW - Isolated limb perfusion
KW - Response evaluation
KW - Soft-tissue sarcoma
UR - http://www.scopus.com/inward/record.url?scp=85165117458&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2023.112949
DO - 10.1016/j.ejca.2023.112949
M3 - Article
C2 - 37453241
AN - SCOPUS:85165117458
SN - 0959-8049
VL - 190
JO - European Journal of Cancer
JF - European Journal of Cancer
M1 - 112949
ER -