Regional perfusion for osteogenic sarcoma of extremities. Long term results for limb salvage in primary advanced disease-and local control in presence of lung metastases

Locally advanced osteogenic sarcoma of the extremities always offers poor results in term of local response and overall survival. The aim of this paper is to present long term results of two series of patients treated with hyperthermic perfusion (HP). Patients are divided into two groups: one with the goal of limb salvage and the second, represented by patients with concurrent lung metastases, where local control in order to avoid amputations, was the goal. In the first group of 16 patients limb salvage was obtained in 13 patients, with good results in term of necrosis of the primary tumour. The second group, with 7 patients, also demonstrated a good outcome: the mean survival was 14 months, with an optimal local control of disease, without any pathological fractures and consequently a good quality of life. In conclusion: HP can play an important role in controlling primary advanced osteogenic sarcoma not responding to pre-operative chemotherapy. The synergistic effect between hyperthermia (41-41,5 °C) and high dose cis-platinum makes it possible to achieve limb salvage.