NEW THERAPEUTIC OPTIONS IN THE TREATMENT OF METASTATIC LIMB SARCOMAS: A CASE SERIES

Palliative procedures are those usually used in the treatment of metastatic limb sarcoma. However given the impressive results obtained with hyperthermic isolated limb perfusion (ILP), we tested the feasibility of isolated lung perfusion (ILuP), using the same regimen. Three patients with multiple metastases from limb sarcoma were included in this study. ILP was applied in one patient resulting in limb preservation. Patients underwent 90- minute ILuP, and subsequent metastasectomy. In all cases the procedure was completed without complications. No systemic toxicity developed. The only postoperative complication was one case of reversible interstitial and alveolar lung edema. The three patients are still alive and two of them were disease-free at a mean follow-up of 19 months. ILuP, with TNF and Melphaln, proved to be feasible and safe. This technique, in association with ILP, might improve long-term survival and quality of life in patients with multiple metastases from limb sarcoma