October 1992

An Evaluation of Two Methods of Limb Salvage in Extremity Soft-Tissue Sarcomas

Author Affiliations

From the Comprehensive Cancer Center and Department of Surgery, Good Samaritan Hospital, Portland, Ore.

Arch Surg. 1992;127(10):1169-1174. doi:10.1001/archsurg.1992.01420100027005

• Between 1983 and 1990, 38 sequential patients with stage II to III soft-tissue sarcoma of the extremities, as defined by the American Joint Committee on Cancer, were treated. Eighteen patients were treated with intra-arterial doxorubicin hydrochloride, limb salvage surgery, and radiation (group A). Twenty patients in group B were treated with cisplatin, isolated limb perfusion, limb salvage surgery, and radiation. The study was not randomized, but all patients were treated prospectively using one of the two protocols. The two groups were similar demographically and had similar lengths of survival without disease. There was only one local recurrence in the series, and this occurred in a group B patient who underwent perfusion with the lowest dose of cisplatin. Regional perfusion with either intra-arterial doxorubicin hydrochloride or cisplatin combined with limb salvage surgery and postoperative radiation are highly effective in preventing local recurrences and preserving functional extremities in patients with soft-tissue sarcoma. There was no difference in results between these two methods.

(Arch Surg. 1992;127:1169-1174)