[Isolated limb perfusion to avoid mutilating surgical resections]

Isolated limb perfusion (ILP) represents a regional oncological therapeutic approach, predominantly applied in the management of locally advanced soft tissue sarcomas of the extremities and malignant melanomas. The technique involves temporary vascular isolation of the affected limb from the systemic circulation, followed by perfusion under strictly controlled hyperthermic conditions using a cytotoxic agent combination, most commonly melphalan in conjunction with human recombinant tumor necrosis factor-alpha. The primary objective of ILP is to achieve high locoregional drug concentrations while limiting systemic exposure, thereby promoting substantial tumor regression and enabling limb preservation. The most commonly reported procedure-related complications include regional and systemic perfusion reactions and postoperative compartment syndrome. When performed in high-volume specialized centers, ILP is regarded as a safe and efficacious treatment modality, with limb preservation rates of up to 93% reported in soft tissue sarcomas.