title: Lower limb function and quality of life after ILP for soft-tissue sarcoma.
abstract: BACKGROUND
  Isolated limb perfusion with TNF-alpha and melphalan (TM-ILP) in combination with complete tumor resection is an effective treatment option for non-resectable soft-tissue sarcoma of the extremities, with limb salvage rates greater than 80%. The aim of this study was to assess quality of life (QoL) after TM-ILP, also with regard to long-term survival.
  
  
  METHODS
  We retrospectively examined 27 patients who had primarily non-resectable soft-tissue sarcoma of the leg and who had undergone TM-ILP and complete tumor resection (with limb-sparing intent) during their follow-up examinations using the Quality of Life Questionnaire (QLQ-C30) and the German Short Musculoskeletal Function Assessment (SMFA-D). The results from the QLQ-C30 were compared to the reference values for the general population, to the "all cancer patients" reference values (both reference values published by the European Organization for Research and Treatment of Cancer (EORTC)), and to the reference values of a historical amputation group from the literature. The results of the SMFA were compared with those from a reference group of healthy individuals.
  
  
  RESULTS
  Surprisingly, we found that the global health status/QoL in the TM-ILP group was not significantly different from the general population or from patients with amputation, but it was higher than that of patients with cancer in general. Concerning the SMFA, we did find functional impairments in patients after TM-ILP compared to the reference group. With regard to long-term survival, we found no time-dependent deterioration in QoL for longer time intervals after treatment.
  
  
  CONCLUSIONS
  These results support the use of TM-ILP in limb-sparing multimodal therapy settings from a quality-of-life perspective, but they also encourage further research on this matter.
authors.affiliation: Sarcoma Surgery Division, Department of General, Visceral and Transplantation Surgery, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany. lars.podleska@uk-essen.de.
authors.forename: Lars Erik
authors.identifier: http://orcid.org/0000-0002-1011-7822
authors.initials: LE
authors.lastname: Podleska
authors.affiliation: Sarcoma Surgery Division, Department of General, Visceral and Transplantation Surgery, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Nevda
authors.initials: N
authors.lastname: Kaya
authors.affiliation: Sarcoma Surgery Division, Department of General, Visceral and Transplantation Surgery, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Farhad
authors.initials: F
authors.lastname: Farzaliyev
authors.affiliation: Department of Radiotherapy, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, 45147, Essen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Pöttgen
authors.affiliation: Department of Medical Oncology, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, 45147, Essen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bauer
authors.affiliation: Sarcoma Surgery Division, Department of General, Visceral and Transplantation Surgery, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Taeger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D010478:Chemotherapy, Cancer, Regional Perfusion; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012509:Sarcoma / Q000188:drug therapy* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014409:Tumor Necrosis Factor-alpha; D008558:Melphalan
keywords: Isolated limb perfusion; Limb function; Long-term survival; Melphalan; Quality of life; Soft-tissue sarcoma; TNF-alpha