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Isolated limb perfusion for locally advanced angiosarcoma in extremities: A multi-centre study.

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Date
2017-11
ICR Author
Jones, Robin
Smith, Henry
Hayes, Andrew
Marsden,
Author
Huis In 't Veld, EA
Grünhagen, DJ
Verhoef, C
Smith, HG
van Akkooi, ACJ
Jones, R
van Coevorden, F
Hayes, AJ
van Houdt, WJ
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Type
Journal Article
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Abstract
Background Angiosarcomas are rare and aggressive soft-tissue sarcomas. The only potential curative treatment is complete surgical excision. This study reports the outcome of isolated limb perfusion (ILP) with high-dose melphalan and tumour necrosis factor α for locally advanced angiosarcoma.Material and methods All patients who underwent an ILP for angiosarcomas between 1991 and 2016 in three tertiary referral centres were identified from prospectively maintained databases.Results A total of 39 patients were included, with a median follow-up of 18 months (interquartile range 6.1-60.8). Of these patients, 23 (58.9%) patients had a complete response (CR) after ILP, 10 (25.6%) had a partial response, 4 (10.3%) had stable disease and 2 (5.1%) patients had progressive disease immediately after ILP. A total of 22 patients developed local progression (56.4%), whereas nine (23.1%) developed distant metastases. The patients with CR had a significantly prolonged median local progression-free survival (PFS) (15.4 versus 7.3 months, p = 0.015) when compared with non-CR patients, and a trend towards better median overall survival (81.2 versus 14.5 months, p = 0.054). Six patients underwent multiple ILPs, whereby the CR rate of the first, second and third ILPs were 60%, 80% and 67%, respectively. Thirteen (33.3%) patients needed further surgical intervention, consisting of resection in eight patients (20.5%) and amputation in five patients (12.8%).Conclusion ILP is an effective treatment option for patients with locally advanced angiosarcoma in the extremities, resulting in a high number of CRs, a high limb salvage rate and prolonged local PFS.
URI
https://repository.icr.ac.uk/handle/internal/1138
DOI
https://doi.org/10.1016/j.ejca.2017.07.023
Collections
  • Clinical Studies
  • Radiotherapy and Imaging
Subject
Extremities
Humans
Hemangiosarcoma
Soft Tissue Neoplasms
Disease Progression
Melphalan
Tumor Necrosis Factor-alpha
Antineoplastic Combined Chemotherapy Protocols
Disease-Free Survival
Treatment Outcome
Retreatment
Limb Salvage
Amputation
Proportional Hazards Models
Risk Factors
Retrospective Studies
Regional Blood Flow
Time Factors
Databases, Factual
Adult
Aged
Aged, 80 and over
Middle Aged
London
Netherlands
Female
Male
Chemotherapy, Cancer, Regional Perfusion
Young Adult
Kaplan-Meier Estimate
Research team
Sarcoma Clinical Trials (R Jones)
Sarcoma and Melanoma Surgery
Language
eng
Date accepted
2017-07-18
License start date
2017-11
Citation
European journal of cancer (Oxford, England : 1990), 2017, 85 pp. 114 - 121

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