Original Article

Limb Salvage in Osteogenic Sarcoma of Extremities: A New Therapeutic Approach Associating Infusion and Hyperthermic Antiblastic Perfusion

^* Direct communications: Dr. Maurizio Vaglini, Division of Surgical Oncology “B,” National Cancer Institute, Via Venezian 1, 20133 MILAN (Italy)

Abstract

(J. Extra-Corpor. Technol. 19[3] p. 338-347 Fall 1987, 49 ref.) From August 1983 to September 1986, 17 patients affected by osteogenic sarcoma of extremities were admitted to our Division with only surgical alternatives of amputation or disarticulation due to the impressive local extension of disease.

Trying to avoid this procedure we started a program of limb salvage as follows: two cycles of intraarterial cis-platinum (CCDP) plus systemic high dose of methotrexate (HDMTX) followed by hyperthermic antiblastic perfusion (HAP) with high dose COOP and for the majority of patients 2 more cycles of systemic HDMTX + COOP with or without radiotherapy on the primary.

Immediate response, evaluated both in terms of necrosis and of clinical and radiologic reduction of the tumor mass, was so impressive that in 10 patients it was possible to perform a conservative surgery, en bloc resection of the primary tumor plus endoprosthesis, with a satisfactory functional and cosmetic result.

None ofthe patients relapsed locally; 8 developed lung metastases that, whenever possible, were resected.