TNFα-based isolated perfusion for limb-threatening soft tissue sarcomas: State of the art and future trends

Carlo Riccardo Rossi, Simone Mocellin, Pierluigi Pilati, Mirto Foletto, Donato Nitti, Mario Lise

Research output: Contribution to journalArticlepeer-review


The management of limb-threatening soft tissue sarcomas has not yet been standardized. Although local disease control does not affect overall survival, amputation or highly mutilating surgery may be required, which impairs the patient's quality of life. Various neoadjuvant approaches have been proposed to allow limb-sparing surgery for these locally advanced tumors. With TNFα-based hyperthermic isolated limb perfusion, the majority of patients can be spared amputation, with acceptable rates of locoregional and systemic complications. As yet, no other available treatment seems to give comparable results when applied to limb-threatening soft tissue sarcomas. Nevertheless, several issues remain to be addressed, such as the type and dose of drugs, repeatability of the procedure, association with radiotherapy, further indications, and evaluation of response. The authors describe the principles underlying TNFα-based hyperthermic isolated limb perfusion, review the worldwide experience so far published, and discuss the above issues. The potential future developments of this locoregional therapeutic approach will also be reported.

Original languageEnglish
Pages (from-to)291-300
Number of pages10
JournalJournal of Immunotherapy
Issue number4
Publication statusPublished - Jul 2003


  • Hyperthermic isolated limb perfusion
  • Soft tissue sarcoma
  • TNFα

ASJC Scopus subject areas

  • Cancer Research
  • Immunology
  • Pharmacology


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