Isolated Limb Perfusion for Extremity Soft Tissue Sarcoma and Malignant Melanoma

Area of Science:

• Oncology
• Surgical Oncology
• Pharmacology

Background:

• Isolated limb perfusion (ILP) is a regional chemotherapy technique for advanced limb cancers.
• It delivers high drug concentrations locally, reducing systemic toxicity.
• The application of ILP has evolved with new treatment modalities.

Purpose of the Study:

• To review the current evidence and indications for ILP in extremity soft tissue sarcoma (ESTS) and malignant melanoma (MM).
• To provide technical insights from a high-volume UK center.
• To clarify the evolving role of ILP in managing advanced limb malignancies.

Main Methods:

• Literature review of current evidence for ILP in ESTS and MM.
• Analysis of indications for ILP in specific clinical scenarios.
• Presentation of technical considerations from expert experience.

Main Results:

• ILP is indicated for unresectable ESTS, including neoadjuvant therapy for limb preservation and definitive treatment of multifocal disease.
• In MM, ILP is primarily used for unresectable in-transit melanoma.
• ILP is rarely an alternative to amputation for bulky, symptomatic extremity disease.

Conclusions:

• ILP remains a valuable regional treatment for specific advanced extremity sarcomas and melanomas.
• Current indications focus on unresectable disease and limb salvage.
• Technical expertise is crucial for optimizing outcomes in ILP therapy.