000K utf8 1100 2020$c2020-12-21 1500 eng 2050 urn:nbn:de:hbz:465-20240816-085225-7 2051 10.1186/s12957-020-02110-4 3000 Farzaliyev, Farhad 3010 Hardes, Jendrik 3010 Podleska, Lars Erik 3010 Steinau, Hans-Ulrich 3010 Streitbürger, Arne 3010 Taeger, Georg 3010 Touma, Alexander 4000 Efficacy of hyperthermic isolated limb perfusion in the treatment of locally recurrent high-grade soft tissue sarcoma of the extremities [Farzaliyev, Farhad] 4209 Background: This novel study compared the use of tumor necrosis factor (TNF)-alpha and melphalan-based isolated limb perfusion (TM-ILP) to the standard treatment of locally recurrent soft tissue extremity sarcoma. The aim was to assess whether TM-ILP positively influences the recurrence-free survival of locally recurrent high-grade soft tissue sarcoma (STS) of the extremities. Methods: We retrospectively analyzed our clinical database for patients with STS. Variables were analyzed using chi-square test or Mann-Whitney rank-sum test. Furthermore, Kaplan-Meier survival plots were calculated and a proportional hazard regression model was developed. Results: Out of 448 patients with extraabdominal STS treated between August 2012 and December 2015, 52 cases involving 47 patients had locally recurrent STS. Twenty-eight of these patients were treated with TM-ILP prior to surgical resection (TM-ILP-group), and 24 were treated with standard therapy (without TM-ILP). The 3-year recurrence-free survival for the TM-ILP-group was estimated at 75% (95% confidence interval (CI), 71.5–78.5). Local recurrence-free survival in the standard group was significantly lower (LRFS: 43.4%, 95% CI 38.7–48.1, p = 0.026). Multivariable analysis revealed resection with negative margins, lower number of previous recurrences, and TM-ILP as positive predictors for recurrence-free survival. Conclusions: TM-ILP and consecutive resection of residual tumor with negative resection margins significantly improves local recurrence-free survival for patients with a first local recurrence of high-grade STS in the extremities. 4950 https://doi.org/10.1186/s12957-020-02110-4$xR$3Volltext$534 4950 https://nbn-resolving.org/urn:nbn:de:hbz:465-20240816-085225-7$xR$3Volltext$534 4961 https://duepublico2.uni-due.de/receive/duepublico_mods_00077609 5051 610