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Updated: Mar 8, 2026
Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity
Published on: January 31, 2025
[Isolated limb perfusion for liposarcoma : Histopathological response and subgroup analysis after TNF melphalan-based
L E Podleska1, B Schwindenhammer2, F Grabellus2
1Sektion Sarkomchirurgie, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Essen, Westdeutsches Tumorzentrum (WTZ), Hufelandstr. 55, 45147, Essen, Deutschland. lars.podleska@uk-essen.de.
Tumor necrosis factor alpha (TNF) and melphalan-based isolated limb perfusion (TM-ILP) effectively treats soft tissue sarcoma (STS). Liposarcomas (LS) respond similarly to non-lipomatous STS, with myxoid LS showing better outcomes than non-myxoid LS and atypical lipomatous tumors.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Soft tissue sarcoma (STS) is a heterogeneous group of tumors.
- Tumor necrosis factor alpha (TNF) and melphalan-based isolated limb perfusion (TM-ILP) is a key treatment for unresectable STS.
- Liposarcomas (LS) represent a significant subgroup of STS with varied prognoses.
Purpose of the Study:
- To evaluate the efficacy of TM-ILP in liposarcomas (LS) and its subtypes.
- To compare the response of LS to TM-ILP against non-lipomatous STS.
- To assess TM-ILP's impact on R0 resection rates in LS.
Main Methods:
- A retrospective analysis of 126 patients who underwent TM-ILP for STS followed by resection.
- Identification of 24 LS patients within the cohort.
- Histopathological regression assessment and comparison between LS and non-LS groups, and within LS subtypes (myxoid, non-myxoid, atypical lipomatous tumors).
Main Results:
- Overall tumor regression rates were comparable between LS (median 90%) and non-LS (median 95%) STS.
- Myxoid LS demonstrated a higher regression rate (median 95%) compared to non-myxoid LS (median 75%).
- Atypical lipomatous tumors (ALT) exhibited the lowest response rate (median 40%).
Conclusions:
- LS shows a comparable histopathological response to TM-ILP as other STS subtypes.
- Myxoid LS and non-myxoid LS exhibit differential responses to TM-ILP, with myxoid subtypes responding better.
- TM-ILP facilitates successful R0 resection in STS, including LS, though further research in subgroups is warranted.
