caa a22 4500 445338105 CHVBK 20180317142802.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1245/s10434-010-1400-x doi (NATIONALLICENCE)springer-10.1245/s10434-010-1400-x Radiotherapy for Soft Tissue Sarcomas after Isolated Limb Perfusion and Surgical Resection: Essential for Local Control in All Patients? [Elektronische Daten] [Jan Deroose, Jacobus Burger, Albertus van Geel, Michael den Bakker, Johannes de Jong, Alexander Eggermont, Cornelis Verhoef] Background: Standard treatment for localized soft tissue sarcoma (STS) is resection plus adjuvant radiotherapy (RTx). In approximately 10% of cases, resection would cause severe loss of function or even require amputation because of the extent of disease. Isolated limb perfusion (ILP) with tumor necrosis factor alpha (TNF-α) and melphalan can achieve regression of the tumor, facilitating limb-saving resection. RTx improves local control but may lead to increased morbidity. Methods: In our database of over 500 ILPs, 122 patients with unifocal STS were treated by ILP followed by limb-sparing surgery. All included patients were candidates for amputation. Results: Surgery resulted in 69 R0 resections (57%), and in 53 specimens (43%) resection margins contained microscopic evidence of tumor (R1). Histopathological examination revealed>50% ILP-induced tumor necrosis in 59 cases (48%). RTx was administered in 73 patients (60%). Local recurrence rate was 21% after median follow-up of 31months (2-182months). Recurrence was significantly less in patients with>50% ILP-induced necrosis versus≤50% necrosis (7% vs. 33%, P=0.001). A similar significant correlation was observed for R0 versus R1 resections (15% vs. 28%, P=0.04). In 36 patients with R0 resection and>50% necrosis, of whom 21 were spared RTx, no recurrences were observed during follow-up. Conclusions: In patients with locally advanced primary STS, treated with ILP followed by R0 resection, and with>50% ILP-induced necrosis in the resected specimen, RTx is of no further benefit. The Author(s), 2010 Deroose Jan Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut Burger Jacobus Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut van Geel Albertus Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut den Bakker Michael Division of Pathology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk 301, Rotterdam, EA, The Netherlands aut de Jong Johannes Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut Eggermont Alexander Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut Verhoef Cornelis Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 321-327 1068-9265 18:2<321 2011 18 10434 https://doi.org/10.1245/s10434-010-1400-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1400-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Deroose Jan Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Burger Jacobus Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Geel Albertus Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- den Bakker Michael Division of Pathology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk 301, Rotterdam, EA, The Netherlands aut NATIONALLICENCE 700 1- de Jong Johannes Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Eggermont Alexander Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Verhoef Cornelis Division of Surgical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/2(2011-02-01), 321-327 1068-9265 18:2<321 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer