title: Impact of hyperthermic isolated limb perfusion on tumour oxygenation in soft tissue sarcoma.
abstract: OBJECTIVE
  Hyperthermic isolated limb perfusion (ILP) with recombinant tumour necrosis factor alpha (TNF) and melphalan contributes to limb-saving treatment in patients with locally advanced extremity soft tissue sarcoma (STS). This study was conducted to evaluate the dynamic changes of tumour oxygenation and temperature during ILP and their effects on treatment response.
  
  
  METHODS
  Tumour oxygenation (pO(2)) and tumour temperature were measured by intratumourally placed O(2)-sensitive catheter electrodes in 34 patients who underwent ILP for locally advanced or recurrent STS. Tumour response to ILP was assessed by the fraction of tumour necrosis in the resection specimen.
  
  
  RESULTS
  Mean tumour pO(2) prior to application of TNF and melphalan was 36 mm Hg (range: 2-116 mm Hg) and dropped significantly to 13 mm Hg (range: 0-67 mm Hg, p = 0.03) during ILP. Mean tumour tissue temperature increased from 34.4°C (range 32.4-36.4) to 38.5°C (range 34.1-40.4, p = 0.0001). The mean fraction of necrosis in the resection specimen was 65% (range 5-99). Only the tumour tissue temperature at the onset of ILP correlated with the extent of tumour necrosis (p = 0.01).
  
  
  CONCLUSIONS
  ILP with TNF and melphalan induces severe oxygen deprivation in soft tissue sarcoma. However, changes in tumour oxygenation did not correlate with treatment response.
authors.affiliation: Division of Surgical Oncology and Thoracic Surgery, Department of Surgery, Mannheim University Medical Centre and Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany. jens.jakob@umm.de
authors.forename: Jens
authors.initials: J
authors.lastname: Jakob
authors.forename: Inez
authors.initials: I
authors.lastname: von Rege
authors.forename: Christel
authors.initials: C
authors.lastname: Weiss
authors.forename: Peter
authors.initials: P
authors.lastname: Hohenberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001831:Body Temperature; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D035002:Lower Extremity; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D012509:Sarcoma / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D012983:Soft Tissue Neoplasms / Q000378:metabolism / Q000473:pathology / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use; D034941:Upper Extremity; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014409:Tumor Necrosis Factor-alpha; D008558:Melphalan; D010100:Oxygen