Advertisement

Clinical and Histopathological Aspects of Hyperthermic Isolated Regional Perfusion of Soft Tissue Sarcomas of the Extremities

  • H. J. Hoekstra
  • W. M. Molenaar
  • H. Schraffordt Koops
  • J. Oldhoff
Conference paper

Abstract

The treatment of a soft tissue sarcoma (STS) of an extremity depends on the location and size of the tumor, the histological diagnosis and tumor grade, the tumor stage, and the previous therapy. Limb salvage and prevention of local recurrence are the two major considerations in the treatment of a malignant STS of an extremity. After inadequate therapy, there is a grave risk of local recurrence, which generally occurs within two years [16]. This is why “unresectable” STS of an extremity have been treated preferably by amputation of the limb. Hyperthermic isolated regional perfusion was introduced into the treatment of STS of the extremity with the idea of increasing the resectability rate without increasing the risk of local recurrence [9]. The rationale of combined modality therapy is that with hyperthermic isolated regional perfusion the tumor and adjacent tissue can be treated with high doses of chemotherapeutic agents and that hyperthermia enhances the sensitivity of tumor cells to chemotherapy [3, 4, 19].

Keywords

Soft Tissue Sarcoma Limb Salvage Regional Perfusion Combine Modality Therapy Clear Cell Sarcoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Beahrs OH, Myers MH (eds) (1983) Manual for staging of cancer: soft tissues. American Joint Committee on Cancer, 2nd edn. Lippincott, Philadelphia, pp 111–115Google Scholar
  2. 2.
    Braat RP, Wieberdink J, van Slooten EA, Olthuis G (1983) Regional perfusion with Adriamycin in soft tissue sarcomas. In: Schwemmle K, Aignerk (eds) Vascular perfusion in cancer therapy. Springer, Berlin Heidelberg New York, Recent results in cancer research, vol 86, pp 260–263Google Scholar
  3. 3.
    Cavaliere R, Ciogatto EC, Giovanella BC et al. (1967) Selective heat sensitivity of cancer cells: biochemical and clinical studies. Cancer 20:1351–1381PubMedCrossRefGoogle Scholar
  4. 4.
    Creech O Jr, Krementz ET, Ryan RF, Winblad JN (1958) Chemotherapy for cancer. Ann Surg 148:616–632PubMedCrossRefGoogle Scholar
  5. 5.
    Eilber FR, Morton DL, Eckhardt J, Grant TT, Weisenburger T (1984) Limb salvage for skeletal and soft tissue sarcomas. Multidisciplinary preoperative therapy. Cancer 53:2579–2584PubMedCrossRefGoogle Scholar
  6. 6.
    Filippo FD, Calabro AM, Cavallari A et al. (1988) The role of hyperthermic perfusion as a first step in the treatment of soft tissue sarcoma of the extremities. World J Surg 12: 332–339PubMedCrossRefGoogle Scholar
  7. 7.
    Fontijne WPJ, Mook PH, Schraffordt Koops H, Oldhoff J, Wildevuur ChRH (1985) Improved tissue perfusion during pressure regulated hyperthermic regional perfusion: a clinical study. Cancer 3:278–284Google Scholar
  8. 8.
    Ghussen F, Nagel K (1984) Die regionale hypertherme Cytostatica perfusion als Alternative bei der Behandlung von malignen Weichgewebetumoren der Extremitäten. Chirurg 55:505–507PubMedGoogle Scholar
  9. 9.
    Hoekstra HJ, Schraffordt Koops H, Molenaar WM, Oldhoff J (1987) Results of isolated regional perfusion in the treatment of malignant soft tissue tumors of the extremities. Cancer 60:1703–1707PubMedCrossRefGoogle Scholar
  10. 10.
    Hoekstra HJ, Schraffordt Koops H, Molenaar WM et al. (1989) A combination of intraarterial chemotherapy, pre-and postoperative radiotherapy and surgery as limb-saving treatment of primarily “unresectable” high grade soft tissue sarcomas of the extremities Cancer 63:59–62Google Scholar
  11. 11.
    Krementz ET (1986) Regional perfusion: current sophistication, what next? Cancer 3:416–432CrossRefGoogle Scholar
  12. 12.
    Lehti PM, Moseley HS, Janoff K, Stevens K, Fletcher WS (1986) Improved survival for soft tissue sarcoma of the extremities by regional hyperthermic perfusion, local excision and radiation therapy. Surg Gynecol Obstet 162:149–152PubMedGoogle Scholar
  13. 13.
    Lejeune FJ, Lienard D, Ewalenko P (1988) Hyperthermic isolation perfusion of the limbs with cytostatics after surgical excision of sarcomas. World J Surg 12:345–348PubMedCrossRefGoogle Scholar
  14. 14.
    McBride CM (1974) Sarcomas of the limbs: results of adjuvant chemotherapy using isolation perfusion. Arch Surg 109:304–308PubMedGoogle Scholar
  15. 15.
    Molenaar WM, Hoekstra HJ, Dam-Meiring A (1990) Histopathological aspects and DNA ploidy in soft tissue sarcomas treated with combined modality therapy. In preparationGoogle Scholar
  16. 16.
    Chang AE, Rosenberg SA, Glatstein EJ, Antham KH (1989) Sarcomas of soft tissues. In: DeVita VT, Hellman S, Rosenberg SA (eds) Cancer principles and practice of oncology, 3rd edn. Lippincott, Philadelphia, pp 1345–1398Google Scholar
  17. 17.
    Schraffordt Koops H (1972) Prevention of neural and muscular lesions during hyperthermic regional perfusion. Surg Gynecol Obstet 135:401–403PubMedGoogle Scholar
  18. 18.
    Schraffordt Koops H, Oldhoff J, Oosterhuis JW, Beekhuis H (1987) Isolated perfusion in malignant melanoma of the extremities. World J Surg 11:527–533PubMedCrossRefGoogle Scholar
  19. 19.
    Stehlin JS Jr (1969) Hyperthermic perfusion with chemotherapy for cancers of the extremities. Surg Gynecol Obstet 129:305–308PubMedGoogle Scholar
  20. 20.
    Stehlin JS, Delpolyi PD, Giovanella BC, Guiterrez AE, Anderson RF (1975) Soft tissue sarcomas of the extremity: multidisciplinary therapy employing hyperthermic perfusion. Am J Surg 130:643–646PubMedCrossRefGoogle Scholar
  21. 21.
    Suit HD, Russell WO, Martin RG (1975) Sarcoma of soft tissue: Clinical and histopathologic parameters and response to treatment. Cancer 35:1478–1483PubMedCrossRefGoogle Scholar
  22. 22.
    van Os J, Schraffordt Koops H, Oldhoff J (1985) Dosimetry of cytostatics in hyperthermic regional isolated perfusion. Cancer 3:698–701Google Scholar
  23. 23.
    Wieberdink J, Benkhuizen C, Braat RP, van Slooten EA, Olthuis GAA (1982) Dosimetry in isolated perfusion of the limbs by assessment of perfused tissue volume and grading of toxic reaction. Eur J Cancer Clin Oncol 18:905–910PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • H. J. Hoekstra
    • 1
  • W. M. Molenaar
    • 1
  • H. Schraffordt Koops
    • 1
  • J. Oldhoff
    • 1
  1. 1.Division of Surgical OncologyGroningen University HospitalGroningenThe Netherlands

Personalised recommendations