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1. Osei DA, Alvandi F, Brooks JS, Ogilvie CM: PEComa of the Upper Extremity: A Unique Case and Description of an Initial Response to Neoadjuvant Chemotherapy. Sarcoma; 2007;2007:53056
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  • [Title] PEComa of the Upper Extremity: A Unique Case and Description of an Initial Response to Neoadjuvant Chemotherapy.
  • Purpose. Tumors of the perivascular epithelial cell tumor (PEComa), first described in 1992, represent a rare soft tissue neoplasm of varying malignant potential.
  • To date, most malignant cases of PEComa have been resistant to chemotherapy, and as such, an appropriate therapy is not known.
  • Case report. Here we describe the first case of PEComa of the upper extremity.
  • Open biopsy revealed a high-grade malignant lesion, and the patient subsequently underwent both neoadjuvant therapy with doxorubicin, ifosfamide and mensa, and radiation therapy prior to wide surgical resection.
  • After six cycles of chemotherapy, the tumor underwent an 80% reduction in size.
  • Subsequent neoadjuvant radiation therapy of 5000 cGy did not further reduce the size of the tumor.
  • Following limb sparing radical resection, pathology showed 20% necrosis within a high-grade malignant lesion.
  • Twenty one months after beginning treatment, the patient shows no sign of local recurrence, but metastatic disease was confirmed after resection of a lung nodule.
  • Conclusion. Given the favorable albeit partial response seen in this patient, the course of therapy outlined here may represent a good starting point for neoadjuvant treatment in a tumor with a historically bleak prognosis.
  • In addition, the diagnosis of PEComa must now be entertained in the differential diagnosis of upper extremity soft tissue sarcoma.

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  • (PMID = 18274609.001).
  • [ISSN] 1357-714X
  • [Journal-full-title] Sarcoma
  • [ISO-abbreviation] Sarcoma
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2225462
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2. Grunhagen DJ, de Wilt JH, Graveland WJ, van Geel AN, Eggermont AM: The palliative value of tumor necrosis factor alpha-based isolated limb perfusion in patients with metastatic sarcoma and melanoma. Cancer; 2006 Jan 1;106(1):156-62
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  • [Title] The palliative value of tumor necrosis factor alpha-based isolated limb perfusion in patients with metastatic sarcoma and melanoma.
  • BACKGROUND: Both patients with soft tissue sarcoma (STS) and patients with melanoma have limited treatment possibilities once the tumor has metastasized systemically.
  • In patients with extremity STS or bulky melanoma in-transit metastases, the local tumor burden may be so problematic that, even in patients with systemically metastasized disease, an amputation may be inevitable.
  • Isolated limb perfusion (ILP) has proven to be an excellent, local, limb-saving treatment option in patients with locally advanced extremity tumors.
  • In this study, the authors investigated the palliative value of the ILP procedure to avoid amputation in patients who had Stage IV STS and melanoma.
  • METHODS: From 1991 to 2003, of 339 tumor necrosis factor alpha (TNF)-based ILPs, 51 procedures were performed for either Stage IV STS (n = 37 patients) or Stage IV melanoma (n = 14 patients).
  • All patients underwent an ILP with TNF and melphalan of the upper limb (n = 4 patients) or the lower limb (n = 47 patients) with 26-140 mg melphalan and 2-4 mg TNF.
  • Limb salvage was achieved in 36 of 37 patients, with 1 patient undergoing amputation due to treatment toxicity.
  • All patients with melanoma preserved their limb during a median survival of 7 months.
  • CONCLUSIONS: TNF-based ILP is an excellent procedure that provided tumor control and limb salvage for the short survival of patients with metastasized, very bulky, limb-threatening tumors of the extremity.
  • [MeSH-major] Antineoplastic Agents, Alkylating / therapeutic use. Chemotherapy, Cancer, Regional Perfusion. Melanoma / drug therapy. Melphalan / therapeutic use. Palliative Care. Sarcoma / drug therapy. Tumor Necrosis Factor-alpha / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Amputation. Arm. Female. Humans. Leg. Male. Middle Aged. Neoplasm Metastasis. Neoplasm Staging. Recombinant Proteins / administration & dosage. Recombinant Proteins / adverse effects. Recombinant Proteins / therapeutic use

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  • [Copyright] Copyright 2005 American Cancer Society.
  • (PMID = 16323177.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Recombinant Proteins; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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3. Di Filippo F, Giacomini P, Rossi CR, Santinami M, Garinei R, Anzà M, Deraco M, Botti C, Perri P, Cavaliere F, Di Angelo P, Sofra C, Sperduti I, Pasqualoni R, Di Filippo S, Corrias F, Armenti A, Ferraresi V: Hyperthermic isolated perfusion with tumor necrosis factor-alpha and doxorubicin for the treatment of limb-threatening soft tissue sarcoma: the experience of the Italian Society of Integrated Locoregional Treatment in Oncology (SITILO). In Vivo; 2009 Mar-Apr;23(2):363-7
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  • [Title] Hyperthermic isolated perfusion with tumor necrosis factor-alpha and doxorubicin for the treatment of limb-threatening soft tissue sarcoma: the experience of the Italian Society of Integrated Locoregional Treatment in Oncology (SITILO).
  • BACKGROUND: Tumor necrosis factor-alpha (TNFalpha)-based hyperthermic isolated limb perfusion (HILP) is routinely carried out at most oncological institutions in the treatment of locally advanced soft tissue limb sarcoma (STS), employing high TNFalpha dosages.
  • After a phase I-II study, the SITILO (Italian Society of Integrated Locoregional Therapies in Oncology) centers began to employ the lower dose of 1 mg of TNFalpha.
  • The aim of this paper is to report on the results obtained in 75 patients with limb-threatening STS treated with a low TNFalpha dose and doxorubicin (Dx).
  • PATIENTS AND METHODS: HILP with TNFalpha (at a dosage of either <or=1 mg or >1 mg) and Dx was administered to 75 patients with limb-threatening STS: 37 males and 38 females; median age 50 years; tumor in the lower and upper limbs in 58 and 17 patients, respectively; primary and recurrent tumors in 45 and 30 patients, respectively.
  • Tumor resection was carried out 6 to 8 weeks after HILP.
  • RESULTS: The grade of limb toxicity was mild to moderate in the vast majority of patients (76%).
  • Complete and partial tumor responses were 34% and 48%, respectively, with an overall response of 82% .
  • Limb sparing surgery was carried out in 85.3% of patients.
  • CONCLUSION: HILP with 1 mg of TNFalpha is an effective neoadjuvant therapy resulting in a high rate of limb sparing in limb-threatening STS, with acceptable local reactions and negligible systemic toxicity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Doxorubicin / administration & dosage. Hyperthermia, Induced. Sarcoma / drug therapy. Soft Tissue Neoplasms / drug therapy. Tumor Necrosis Factor-alpha / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chemotherapy, Cancer, Regional Perfusion / methods. Disease-Free Survival. Extremities / pathology. Female. Humans. Male. Middle Aged. Perfusion. Recurrence. Treatment Outcome

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  • (PMID = 19414428.001).
  • [ISSN] 0258-851X
  • [Journal-full-title] In vivo (Athens, Greece)
  • [ISO-abbreviation] In Vivo
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha; 80168379AG / Doxorubicin
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4. Germain MA, Bonvalot S, Rimareix F, Missana CM: [Locally advanced soft-tissue sarcomas. An innovating triad to avoid amputation: isolated limb perfusion, TNFalpha, and free microsurgical flap]. Bull Acad Natl Med; 2010 Jan;194(1):51-65; discussion 65-7
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  • [Title] [Locally advanced soft-tissue sarcomas. An innovating triad to avoid amputation: isolated limb perfusion, TNFalpha, and free microsurgical flap].
  • [Transliterated title] Sauvetage des membres atteints de sarcome localement evolué. La triade innovante: perfusion de membre isole sous CEC, TNFalpha, et transplant microchirurgical.
  • We retrospectively studied the benefits of isolated limb perfusion combined with TNFalpha administration and free flap reconstruction in locally advanced soft-tissue sarcomas of the limbs.
  • Between 2000 and 2008, we treated 37 patients (22 women and 15 men) with locally advanced soft tissue sarcomas.
  • The sarcomas were located in the lower and upper limbs in respectively 26 and 11 cases, and had a mean diameter of 15 cm and 12 cm, respectively.
  • Seventeen patients received neoadjuvant chemotherapy.
  • Sarcoma excision was combined with a complementary procedure in 10 patients (vascular graft or nerve anastomosis).
  • Three major improvements were made in recent years, namely isolated limb perfusion, TNFalpha administration, and free flap reconstruction two months after resection of residual sarcoma.
  • The procedure lasted a median of 7 hours.
  • Tumor excision was stage R0 in 29 cases (clean margins), R1 in 7 cases (microscopic residue), and R2 in one case (macroscopic residue).
  • The limb was preserved in 78% of cases.
  • Thirteen patients developed pulmonary metastases and seven of them died between the first and fifth years of follow-up.
  • Isolated limb perfusion and free flap reconstruction permitted more extensive tumor excision.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Cancer, Regional Perfusion. Extremities / surgery. Sarcoma / drug therapy. Sarcoma / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery. Tumor Necrosis Factor-alpha / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Lung Neoplasms / mortality. Lung Neoplasms / secondary. Male. Middle Aged. Muscle, Skeletal / transplantation. Neoadjuvant Therapy. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / surgery. Neoplasms, Radiation-Induced / drug therapy. Neoplasms, Radiation-Induced / surgery. Neoplasms, Second Primary / drug therapy. Neoplasms, Second Primary / surgery. Radiotherapy, Adjuvant. Reconstructive Surgical Procedures. Reoperation. Retrospective Studies. Skin Transplantation. Surgical Flaps. Treatment Outcome. Young Adult

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  • (PMID = 20669559.001).
  • [ISSN] 0001-4079
  • [Journal-full-title] Bulletin de l'Académie nationale de médecine
  • [ISO-abbreviation] Bull. Acad. Natl. Med.
  • [Language] fre
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha
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5. Hoekstra HJ, van Ginkel RJ: Hyperthermic isolated limb perfusion in the management of extremity sarcoma. Curr Opin Oncol; 2003 Jul;15(4):300-3
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  • [Title] Hyperthermic isolated limb perfusion in the management of extremity sarcoma.
  • High local drug concentrations can be achieved in a limb with minimal systemic toxicity with the technique of hyperthermic isolated limb perfusion (HILP).
  • The currently most successful drugs are still Tumor Necrosis Factor alpha (TNFalpha) and melphalan.
  • With HILP, as an induction chemotherapy treatment of locally advanced primarily irresectable soft tissue sarcomas of a limb, a limb salvage rate of 71% can be achieved, with a minimal treatment related morbidity.
  • For the HILP is no upper age limit.
  • Experimental work is now directed to the development of drugs sensitizing the tumor vasculature to the effects of TNFalpha.
  • Although multidrug resistance (MDR) is a major issue in effectiveness of chemotherapy in human cancer treatment, HILPs with TNFalpha and melphalan did not induce MDR in sarcomas.
  • The future research in HILP with TNFalpha is directed in increasing tumor sensitivity for TNF with lowering the dosage without decreasing tumor response.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Hyperthermia, Induced. Melphalan / administration & dosage. Sarcoma / therapy. Soft Tissue Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Cancer, Regional Perfusion. Extremities. Humans. Tumor Necrosis Factor-alpha / administration & dosage. Tumor Necrosis Factor-alpha / therapeutic use

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  • (PMID = 12874508.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
  • [Number-of-references] 12
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6. Bonvalot S, Rimareix F, Causeret S, Le Péchoux C, Boulet B, Terrier P, Le Cesne A, Muret J: Hyperthermic isolated limb perfusion in locally advanced soft tissue sarcoma and progressive desmoid-type fibromatosis with TNF 1 mg and melphalan (T1-M HILP) is safe and efficient. Ann Surg Oncol; 2009 Dec;16(12):3350-7
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  • [Title] Hyperthermic isolated limb perfusion in locally advanced soft tissue sarcoma and progressive desmoid-type fibromatosis with TNF 1 mg and melphalan (T1-M HILP) is safe and efficient.
  • BACKGROUND: In a prior randomized phase II trial comparing hyperthermic isolated limb perfusion (HILP) with four different doses of tumor necrosis factor alpha (TNF-alpha), no dose effect was detected for response, but systemic toxicity was far lower with low-dose TNF-alpha.
  • The objective of the present study was to confirm these data on a larger sample size of locally advanced or recurrent extremity soft tissue sarcomas with low-dose TNF-alpha.
  • The remnant tumor was resected 2 months later.
  • The site/size were: 30 patients/57 mm and 70 patients/86 mm for the upper and lower limbs, respectively.
  • Tumor grades (FNCLCC) were 1 (23 patients), 2 (34 patients), and 3 (43 patients).
  • Fifty-one patients had received systemic chemotherapy before HILP.
  • Age, sex, tumor size, recurrence, uni- or multifocality, grade, preoperative chemotherapy, and a previously irradiated field were not predictive of response or local toxicity.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Chemotherapy, Cancer, Regional Perfusion. Extremities / pathology. Fibromatosis, Aggressive / therapy. Hyperthermia, Induced. Melphalan / administration & dosage. Sarcoma / therapy. Tumor Necrosis Factor-alpha / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Aged. Drug Therapy, Combination. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Prospective Studies. Survival Rate. Young Adult

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  • (PMID = 19830495.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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7. Hegazy MA, Kotb SZ, Sakr H, El Dosoky E, Amer T, Hegazi RA, Farouk O: Preoperative isolated limb infusion of Doxorubicin and external irradiation for limb-threatening soft tissue sarcomas. Ann Surg Oncol; 2007 Feb;14(2):568-76
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  • [Title] Preoperative isolated limb infusion of Doxorubicin and external irradiation for limb-threatening soft tissue sarcomas.
  • BACKGROUND: At present, limb-sparing surgery is the most appropriate and acceptable treatment option for soft tissue sarcomas of the extremities.
  • To increase the number of limb-sparing resections in the treatment of locally advanced soft tissue sarcomas of the extremities, preoperative radiotherapy and/or chemotherapy are often used.
  • Isolated limb perfusion of cytostatic agents is an effective alternative option but technically complex.
  • Isolated limb infusion, essentially a low-flow isolated limb perfusion without oxygenation via a percutaneous catheter, had been developed as a simple alternative.
  • OBJECTIVE: The objective of this study was to achieve limb-sparing surgery in patients with locally advanced soft tissue sarcomas of the extremities that would otherwise have required an amputation or a functionally mutilating surgery by performing preoperative isolated limb infusion with doxorubicin and external beam irradiation to obtain local control and make limb-sparing surgery feasible.
  • METHODS: A total of 40 patients with locally advanced soft tissue sarcomas of the extremities were evaluated between 2002 and 2005.
  • Tumors were located in the lower limb in 28 patients (70%) and in the upper limb in 12 patients (30%).
  • All of these patients were felt to be unresectable and were referred because amputation was considered the only available treatment option.
  • They underwent preoperative isolated limb infusion with doxorubicin (0.7 and 1.4 mg/kg for the upper and lower limbs, respectively).
  • Preoperative external beam radiotherapy started within 3-7 days after isolated limb infusion was administered.
  • The total dose was 35 Gy in ten fractions.
  • After 3-7 weeks, surgery was performed aiming at limb preservation.
  • RESULTS: Tumor response was seen in 85% of patients, rendering these large sarcomas resectable in most cases.
  • The mean values of pretreatment tumor volume and post-treatment volume were 2797 cm(3) and 1781 cm(3), respectively, with a significant p value of 0.0001.
  • At a median followup of 15 months (range = 5-35), limb salvage was achieved in 82.5%.
  • Procedure-related complications were limited and easily managed.
  • CONCLUSION: Isolated limb infusion with doxorubicin is a simple and safe method of regional chemotherapy.
  • The addition of preoperative external beam irradiation helped to increase the rate of limb salvage in patients with large and/or high-grade soft tissue sarcomas of the extremities.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion. Sarcoma / therapy. Soft Tissue Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Antibiotics, Antineoplastic / administration & dosage. Combined Modality Therapy. Doxorubicin / administration & dosage. Extremities. Feasibility Studies. Female. Humans. Limb Salvage / methods. Male. Middle Aged. Preoperative Care

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  • (PMID = 17094027.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 80168379AG / Doxorubicin
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8. Murray PM: Soft tissue sarcoma of the upper extremity. Hand Clin; 2004 Aug;20(3):325-33, vii
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  • [Title] Soft tissue sarcoma of the upper extremity.
  • Soft tissue sarcomas of the upper extremities are rare and hand surgeons typically encounter only one or two undiagnosed soft tissue sarcomas during their careers.
  • It is incumbent on the physician to review repeatedly the characteristics of these tumors and remain suspicious, because these lesions typically are misdiagnosed and treatment is delayed.
  • The most common soft tissue sarcomas of the upper extremity are the epithelioid sarcoma, synovial cell sarcoma, and malignant fibrous histiocytoma.
  • Limb salvage surgery is the treatment of choice for soft tissue sarcomas to preserve upper extremity function.
  • Following wide tumor resection, adjuvant therapies such as chemotherapy, external beam radiation therapy, and brachytherapy may lessen local recurrence rates, but their effect on overall survival remains unclear.
  • [MeSH-major] Sarcoma. Soft Tissue Neoplasms
  • [MeSH-minor] Arm. Biopsy. Chemotherapy, Adjuvant. Dermatofibrosarcoma / diagnosis. Dermatofibrosarcoma / surgery. Fibrosarcoma / pathology. Fibrosarcoma / therapy. Histiocytoma, Benign Fibrous / mortality. Histiocytoma, Benign Fibrous / pathology. Humans. Liposarcoma / pathology. Neoplasm Metastasis. Neoplasm Recurrence, Local. Prognosis. Rhabdomyosarcoma / pathology. Rhabdomyosarcoma / therapy. Sarcoma, Clear Cell / diagnosis. Sarcoma, Synovial / diagnosis

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  • (PMID = 15275691.001).
  • [ISSN] 0749-0712
  • [Journal-full-title] Hand clinics
  • [ISO-abbreviation] Hand Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 46
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9. Leit ME, Tomaino MM: Principles of limb salvage surgery of the upper extremity. Hand Clin; 2004 May;20(2):v, 167-79
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  • [Title] Principles of limb salvage surgery of the upper extremity.
  • The goals of limb salvage surgery in the upper extremity are to achieve resection of the tumor and preserve hand function without the risk for local recurrence.
  • Historically, amputation was the treatment of choice for a neoplasm of the hand, wrist, and forearm, but limb-sparing procedures have become feasible largely because of advances in diagnostic imaging, reconstructive microsurgery, and adjuvant radiotherapy and chemotherapy.
  • Because preservation of hand function, even modest levels thereof, is clearly superior to amputation from a functional standpoint, the authors review the principles of limb salvage in this article.
  • [MeSH-major] Bone Neoplasms / surgery. Limb Salvage. Soft Tissue Neoplasms / surgery
  • [MeSH-minor] Bone Transplantation. Fibula / transplantation. Forearm. Giant Cell Tumor of Bone / surgery. Hand. Humans. Prostheses and Implants. Surgical Flaps

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  • (PMID = 15201022.001).
  • [ISSN] 0749-0712
  • [Journal-full-title] Hand clinics
  • [ISO-abbreviation] Hand Clin
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 60
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10. Lejeune FJ, Pujol N, Liénard D, Mosimann F, Raffoul W, Genton A, Guillou L, Landry M, Chassot PG, Chiolero R, Bischof-Delaloye A, Leyvraz S, Mirimanoff RO, Bejkos D, Leyvraz PF: Limb salvage by neoadjuvant isolated perfusion with TNFalpha and melphalan for non-resectable soft tissue sarcoma of the extremities. Eur J Surg Oncol; 2000 Nov;26(7):669-78
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  • [Title] Limb salvage by neoadjuvant isolated perfusion with TNFalpha and melphalan for non-resectable soft tissue sarcoma of the extremities.
  • AIMS: Patients with non-resectable soft tissue sarcomas of the extremities do not live longer if they are treated by amputation or disarticulation.
  • In order to avoid major amputations, we tested isolated limb perfusion (ILP) with tumour necrosis factor alpha (TNF)+melphalan+/-interferon-gamma (IFN) as a pre-operative, neoadjuvant limb salvage treatment.
  • METHODS: Twenty-two patients were included (six men and 16 women; three upper limb and 19 lower limb tumours).
  • Thirteen cases were recurrent or progressive after previous therapy; five tumours had a diameter >/=20 cm, and four were multiple or regionally metastatic.
  • Three patients had a minimal or no response and the tumour progressed in one case.
  • All patients had fever for 24 hours but only one developed a reversible grade 3 distributive shock syndrome with no sequelae.
  • Seventeen patients (77%) underwent limb-sparing resection of the tumour remnants after a median time of 3.4 months: 10 resections were intracompartmental and seven extracompartmental.
  • Adjuvant chemotherapy was given to eight patients and radiotherapy to six.
  • Secondary amputations were performed for recurrence in two patients, resulting in an overall limb salvage rate of 19/22 (86%).
  • The median disease free and overall survival times have been >12.5 and 18.7 months respectively: this is similar to the outcome after primary amputations for similar cases.
  • CONCLUSION: ILP with TNF and chemotherapy is an efficient limb sparing neoadjuvant therapy for a priori non-resectable limb soft tissue sarcomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Leg / surgery. Sarcoma / drug therapy. Sarcoma / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Chemotherapy, Cancer, Regional Perfusion. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Interferon-gamma / administration & dosage. Interferon-gamma / adverse effects. Male. Melphalan / administration & dosage. Melphalan / adverse effects. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / surgery. Radiotherapy, Adjuvant. Salvage Therapy. Survival Analysis. Tumor Necrosis Factor-alpha / administration & dosage. Tumor Necrosis Factor-alpha / adverse effects

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 11078614.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha; 80168379AG / Doxorubicin; 82115-62-6 / Interferon-gamma; Q41OR9510P / Melphalan; UM20QQM95Y / Ifosfamide
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11. Kurosawa H, Matsunaga T, Shimaoka H, Sato Y, Kuwashima S, Sugita K, Hagane K, Eguchi M: Burkitt lymphoma associated with large gastric folds, pancreatic involvement, and biliary tract obstruction. J Pediatr Hematol Oncol; 2002 May;24(4):310-2
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  • A 14-year-old boy was referred to the authors' hospital with upper abdominal pain and jaundice.
  • A standard barium upper gastrointestinal series showed large gastric folds in the entire stomach.
  • Magnetic resonance imaging showed a typical diffuse infiltrating type of pancreatic lymphoma.
  • Because complete bilateral lower limb paralysis developed as a result of the epidural soft tissue mass, laminectomy and tumor resection were performed and a diagnosis of disseminated Burkitt lymphoma was established.
  • After completing 6 months of chemotherapy, the patient has been disease-free without neurologic complications for 2.5 years.
  • [MeSH-major] Burkitt Lymphoma / diagnosis. Cholestasis / diagnosis. Gastric Mucosa / pathology. Pancreatic Neoplasms / diagnosis
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Humans. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed

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  • (PMID = 11972102.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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12. Hornick JL, Jaffe ES, Fletcher CD: Extranodal histiocytic sarcoma: clinicopathologic analysis of 14 cases of a rare epithelioid malignancy. Am J Surg Pathol; 2004 Sep;28(9):1133-44
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  • Histiocytic sarcoma is a rare malignant neoplasm that occurs in lymph nodes, skin, and the gastrointestinal tract.
  • Seven tumors arose in soft tissue (6 lower limb; 1 upper limb), 5 in the gastrointestinal tract (1 involving both stomach and colon, 1 ileum, 2 rectum, 1 anus), 1 in the nasal cavity, and 1 in the lung.
  • Binucleated cells were common, and 6 cases contained tumor giant cells.
  • Six patients were treated with postoperative radiation and 7 with chemotherapy (CHOP or ProMACE-MOPP).
  • Two tumors recurred locally, and 5 patients developed distant spread: 3 to lymph nodes, 1 to lung, and 1 to bone.
  • At the last follow-up, 2 patients have died of disseminated disease, 4 and 5 months following initial diagnosis.
  • Histiocytic sarcoma may arise primarily in soft tissue and shows reproducible histologic features, including abundant eosinophilic cytoplasm and a prominent inflammatory infiltrate.
  • Tumor size may be a prognostic factor.

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  • (PMID = 15316312.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Bonvalot S, Laplanche A, Lejeune F, Stoeckle E, Le Péchoux C, Vanel D, Terrier P, Lumbroso J, Ricard M, Antoni G, Cavalcanti A, Robert C, Lassau N, Blay JY, Le Cesne A: Limb salvage with isolated perfusion for soft tissue sarcoma: could less TNF-alpha be better? Ann Oncol; 2005 Jul;16(7):1061-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Limb salvage with isolated perfusion for soft tissue sarcoma: could less TNF-alpha be better?
  • BACKGROUND: The optimal dose of TNF-alpha delivered by isolated limb perfusion (ILP) in patients with locally advanced soft tissue sarcoma is still unknown.
  • PATIENTS AND METHODS: Randomised phase II trial comparing hyperthermic ILP (38-40 degrees ) with melphalan and one of the four assigned doses of TNF-alpha: 0.5 mg, 1 mg, 2 mg, and 3/4 mg upper/lower limb.
  • The main end point was objective tumour response on MRI.
  • Resection of the remnant tumour was performed 2-3 months after ILP.
  • RESULTS: One hundred patients (25 per arm) were included.
  • Objective tumour responses were: 68%, 56%, 72% and 64% in the 0.5 mg, 1 mg, 2 mg and 3 or 4 mg arms, respectively (NS).
  • CONCLUSION: At the range of TNF-alpha doses tested, there was no dose effect detected for the objective tumour response, but systemic toxicity was significantly correlated with higher TNF-alpha doses.

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  • (PMID = 15930042.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha
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14. Asavamongkolkul A, Waikakul S, Phimolsarnti R, Kiatisevi P, Wangsaturaka P: Endoprosthetic reconstruction for malignant bone and soft-tissue tumors. J Med Assoc Thai; 2007 Apr;90(4):706-17
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endoprosthetic reconstruction for malignant bone and soft-tissue tumors.
  • BACKGROUND: Nowadays, the results of the management of malignant bone and soft-tissue tumors have been dramatically improved because of the advance in imaging, chemotherapy, radiation therapy, and surgical techniques.
  • Patients can have longer survival times with limb-salvage surgery.
  • Several techniques of reconstruction have been advocated and gained more popularity following malignant tumor resection by using allograft, tumor prostheses, composite allograft prosthesis, or arthrodesis.
  • OBJECTIVE: To report the preliminary results of 32 endoprosthetic reconstructions following malignant bone and soft-tissue tumor resection.
  • MATERIAL AND METHOD: Since September 1988, the authors have performed 188 limb-salvage surgical operations for the treatment of musculoskeletal tumors at Siriraj Hospital.
  • From March 1994 to July 2006, 32 endoprosthetic reconstructions were performed on 30 patients following malignant bone or soft-tissue tumor removal.
  • The diagnosis was conventional osteosarcoma in 16 patients, parosteal osteosarcoma in two patients, chondrosarcoma in two patients, leiomyosarcoma in two patients, failed allograft in two patients and one patient each of periosteal osteosarcoma, Ewing's sarcoma, Gorham's disease, synovial sarcoma, malignant fibrous histiocytoma, metastatic renal cell carcinoma, and prosthetic loosening.
  • Five proximal femurs, 17 distal femurs, 1 total femur 3 proximal tibias, 1 intercalary tibia, 4 proximal humerus and 1 distal humerus were used for reconstruction.
  • RESULTS: The mean follow-up time was 26 months (range 6-128.7).
  • The mean Musculoskeletal Tumor Society functional analysis for upper extremity reconstruction was 93% (range 86.7-100) and for lower extremity was 89% (range 63.3-100).
  • CONCLUSION: Endoprosthetic reconstruction could yield satisfactory results as a wide excision and limb-salvage for patients with malignant bone and soft-tissue tumors.
  • [MeSH-major] Bone Neoplasms / surgery. Limb Salvage. Osteosarcoma / surgery. Sarcoma, Ewing / surgery. Soft Tissue Neoplasms / surgery

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  • (PMID = 17487125.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Thailand
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15. Nelson AA, Frassica FJ, Gordon TA, Deune EG: Cost analysis of functional restoration surgery for extremity soft-tissue sarcoma. Plast Reconstr Surg; 2006 Jan;117(1):277-83
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  • [Title] Cost analysis of functional restoration surgery for extremity soft-tissue sarcoma.
  • BACKGROUND: Limb-sparing surgery, consisting of wide-margin tumor resection and preoperative or postoperative radiotherapy/chemotherapy, has become the surgical treatment of choice for extremity sarcomas.
  • However, adequate tumor resection can sometimes compromise crucial limb function, necessitating functional restoration surgery.
  • METHODS: Patients receiving either functional restoration surgery or soft-tissue-only reconstruction following extremity soft-tissue sarcoma excision were identified.
  • Patients were then compared along several dimensions: overall length of stay and its subdivisions, surgical time, and total charges and its subdivisions.
  • RESULTS: Sixty-seven patients who underwent 69 limb-sparing procedures were identified.
  • Fifteen of these procedures (eight upper extremity, seven lower extremity) required functional restoration surgery; 54 of these procedures (13 upper extremity, 41 lower extremity) required only soft-tissue coverage.
  • In the upper extremity, there was a statistically significant increase in overall length of stay (2.8 days) and its subdivisions, surgical time (3.7 hours), and total charges (12,484 dollars) and its subdivisions associated with performing functional restoration surgery.
  • CONCLUSION: Although functional restoration surgery is more costly than soft-tissue reconstruction alone, the authors believe that the associated better functional outcome justifies its performance.
  • [MeSH-major] Extremities. Reconstructive Surgical Procedures / economics. Sarcoma / surgery. Soft Tissue Neoplasms / surgery. Surgical Flaps / economics

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  • (PMID = 16404280.001).
  • [ISSN] 1529-4242
  • [Journal-full-title] Plastic and reconstructive surgery
  • [ISO-abbreviation] Plast. Reconstr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Gebhard S, Coindre JM, Michels JJ, Terrier P, Bertrand G, Trassard M, Taylor S, Château MC, Marquès B, Picot V, Guillou L: Pleomorphic liposarcoma: clinicopathologic, immunohistochemical, and follow-up analysis of 63 cases: a study from the French Federation of Cancer Centers Sarcoma Group. Am J Surg Pathol; 2002 May;26(5):601-16
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  • Tumor size ranged from 2 to 23 cm (median 10 cm).
  • Tumor locations included lower extremity (36.5%), especially the thigh (28.5%), limb girdles (17.5%), upper extremity (16%), thoracoabdominal wall (9.5%), and internal trunk (20.5%).
  • Tumor necrosis was observed in 51 (81%) cases, vascular invasion in three, and mitotic counts ranged from 3 to 124 per 10 high power fields (median 25).
  • Treatment procedures in 51 patients consisted of simple tumorectomy (16) and wide excision (33).
  • Five and 31 patients received neoadjuvant and adjuvant chemotherapy and/or radiation therapy, respectively.
  • Seventeen patients (35%) died of disease, of whom none was metastatic at diagnosis.
  • Patient age > or =60 years, truncal tumor location, deep situation, tumor size >5 cm, vascular invasion, and incomplete tumor excision were significant adverse prognostic factors.
  • Tumor grade and histology did not affect patient outcome.
  • In conclusion, pleomorphic liposarcoma is a rare, often deep-seated and limb-based aggressive and metastasizing neoplasm of late adulthood.
  • It shows a wide range of morphologic appearances, but tumor grade and histology have no effect on patient outcome.
  • [MeSH-major] Liposarcoma / pathology. Soft Tissue Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Disease-Free Survival. Female. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Proteins / analysis. Survival Rate. Treatment Outcome

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  • (PMID = 11979090.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Neoplasm Proteins
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17. Issakov J, Merimsky O, Gutman M, Kollender Y, Lev-Chelouche D, Abu-Abid S, Lifschitz-Mercer B, Inbar M, Klausner JM, Meller I: Hyperthermic isolated limb perfusion with tumor necrosis factor-alpha and melphalan in advanced soft-tissue sarcomas: histopathological considerations. Ann Surg Oncol; 2000 Mar;7(2):155-9
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  • [Title] Hyperthermic isolated limb perfusion with tumor necrosis factor-alpha and melphalan in advanced soft-tissue sarcomas: histopathological considerations.
  • BACKGROUND: Hyperthermic isolated limb perfusion with tumor necrosis factor-alpha and melphalan was used as induction treatment in locally advanced extremity soft-tissue sarcomas for limb sparing surgery.
  • METHODS: Fresh tumor specimens of 27 high grade extensive soft-tissue sarcomas and 3 recurrent desmoid tumors of the extremities were collected 6 to 8 weeks after hyperthermic isolated limb perfusion with tumor necrosis factor-alpha plus melphalan.
  • The specimens were studied for surgical margins, extent and type of tumor necrosis, lymph node involvement, perineural and vascular invasion, and the effects on adjacent normal tissues such as nerves, muscles, and blood vessels.
  • Some nonspecific changes were noted in the soft tissues around the mass.
  • The responsive types were malignant fibrous histiocytoma, followed by myxoid liposarcoma and synovial sarcoma.
  • The soft tissues adjacent to the tumor bed did not show major morphological changes.
  • No correlation was found between the histological changes and each of the following: the anatomical (upper vs. lower limb) or compartmental location of the tumor; whether the tumor was primary or recurrent; and the types of previous treatment (systemic chemotherapy or radiotherapy) and tumor size.
  • CONCLUSIONS: This is the first serial histological description of the effects of tumor necrosis factor-alpha and melphalan administered via hyperthermic isolated limb perfusion on the tumoral masses of limb soft-tissue sarcomas.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Chemotherapy, Cancer, Regional Perfusion. Melphalan / administration & dosage. Sarcoma / pathology. Soft Tissue Neoplasms / pathology. Tumor Necrosis Factor-alpha / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Aged. Extremities. Female. Fibrosis. Humans. Hyperthermia, Induced. Male. Middle Aged. Necrosis

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  • (PMID = 10761796.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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18. Takeuchi A, Tsuchiya H, Shirai T, Hayashi K, Nishida H, Tomita K: Occlusive dressing for large soft tissue defects following soft tissue tumor excision. J Orthop Sci; 2009 Jul;14(4):385-90
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  • [Title] Occlusive dressing for large soft tissue defects following soft tissue tumor excision.
  • BACKGROUND: Reconstructive surgery using pedicles or free muscle-skin flaps and skin grafting reduces wound complications and promotes favorable limb function; however, the sacrifice of normal tissue remains problematic and complicated.
  • However, their effectiveness for treating soft tissue defects following a soft tissue tumor excision has not been fully elucidated.
  • The purpose of this study was to evaluate the effectiveness and safety of an occlusive dressing treatment method for soft tissue defects following soft tissue tumor excisions.
  • METHODS: We retrospectively reviewed eight patients (three men, five women) whose wounds were treated with polyurethane foam occlusive dressings to allow reconstruction of the soft tissue defect following soft tissue tumor excision.
  • The treatment periods, incidence of complications, and ultimate outcomes were evaluated.
  • Mean treatment periods were 21.6 weeks (range 13.5-44.0 weeks).
  • CONCLUSIONS: This treatment method is simple, safe, and reliable.
  • We concluded that the highly favorable indications of this treatment are ideal for patients who wish to avoid sacrificing their normal tissue, have no history of radiotherapy before surgery, and do not require chemotherapy or radiotherapy after the operation.
  • [MeSH-major] Occlusive Dressings. Reconstructive Surgical Procedures / methods. Soft Tissue Neoplasms / surgery. Surgical Flaps
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Esthetics. Female. Follow-Up Studies. Graft Rejection. Graft Survival. Humans. Lower Extremity. Middle Aged. Pain Measurement. Postoperative Care / methods. Probability. Retrospective Studies. Risk Assessment. Sampling Studies. Time Factors. Upper Extremity. Wound Healing / physiology. Young Adult

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  • (PMID = 19662471.001).
  • [ISSN] 1436-2023
  • [Journal-full-title] Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
  • [ISO-abbreviation] J Orthop Sci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
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19. Goubier JN, Teboul F, Oberlin C: [Desmoid tumors and brachial plexus]. Chir Main; 2003 Aug;22(4):203-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The aim of our paper is to assess the functional results and specific difficulties encountered in the treatment of desmoid tumors located near the brachial plexus.
  • Seven patients with a desmoid tumor in this region were followed for at least 2 years (average 59 months).
  • Three patient had postoperatively chemotherapy and 1 patient had radiation therapy.
  • At review, none of the 7 patients had had to undergo upper limb amputation and the mean functional results were good or excellent in 6 patients (mean MSTS = 72.8).
  • The margins of desmoid tumor resection have to be wide to avoid local recurrence.
  • However, nerves and blood vessels have to be preserved in order to maintain upper limb function and there may well be a need for adjuvant therapy.
  • [MeSH-major] Brachial Plexus. Fibromatosis, Aggressive / surgery. Soft Tissue Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / epidemiology

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  • (PMID = 14611074.001).
  • [ISSN] 1297-3203
  • [Journal-full-title] Chirurgie de la main
  • [ISO-abbreviation] Chir Main
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 10
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20. Jarmundowicz W, Jabłoński P, Załuski R: [Brachial plexus tumors--neurosurgical treatment]. Neurol Neurochir Pol; 2002 Sep-Oct;36(5):925-35

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Brachial plexus tumors--neurosurgical treatment].
  • Tumours of the brachial plexus according to present classification are included to soft tissue tumours.
  • Therefore the aim of the study was to present our experience in the surgical treatment of tumours of the brachial plexus basing on the material of 5 cases treated in the years 1997-2001.
  • In 3 cases tumours of the brachial plexus invaded the spinal canal through the intervertebral foramen and caused spinal cord compression (type A).
  • In 2 cases tumours involved only plexus elements (type B).
  • In 2 cases tumours were associated with neurofibromatosis type II.
  • In case of a giant schwannoma malignum tumor, which caused flaccid paresis and symptoms of insufficient blood, supply with severe pain in the upper limb radical extirpation was also possible.
  • In type A tumours in the first stage intraspinal part of the tumor was removed.
  • The result of treatment of benign tumours was very good with complete function recovery of the upper limb, pain disappearance and no symptoms of recurrence in the long postoperative period.
  • The patient died 12 months after the operation because of tumor dissemination.
  • In case of malignant tumours many authors also recommend surgery with optimal sparing of the brachial plexus function and subsequent radio and chemotherapy.
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Retrospective Studies. Time Factors. Treatment Outcome

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  • (PMID = 12523117.001).
  • [ISSN] 0028-3843
  • [Journal-full-title] Neurologia i neurochirurgia polska
  • [ISO-abbreviation] Neurol. Neurochir. Pol.
  • [Language] pol
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Poland
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21. Manili M, Fredella N, Santori FS: Shoulder prosthesis in reconstruction of the scapulohumeral girdle after wide resection to treat malignant neoformation of the proximal humerus. Chir Organi Mov; 2002 Jan-Mar;87(1):25-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Progress in preoperative chemotherapy and radiation therapy, both intra- and postoperative, has in time allowed for an increase in indications for shoulder implant surgery in malignant tumors, thus drastically reducing the number of amputations.
  • The use of prostheses, particularly those of the more recent generation, respond to the needs to overcome the limits of loss of movement, as long as good anatomical reconstruction of the soft tissues, the premise for good functional and cosmetic recovery, is also possible.
  • This type of prosthesis has surpassed custom made prostheses in terms of simplicity, adaptability and economy.
  • The main problem in reconstruction with a prosthesis is the quantity of residual muscular tissue (deltoideus, extrarotators) and the stabilization system of the same to the prosthesis in order to avoid dislocation, which constitutes the main complication.
  • It is the purpose of this study to present the clinical and functional results obtained in 23 implants carried out for primary malignant neoformation of the upper limb.
  • The implants studied were of three types (custom made, modular in Cr-Co-Mb and Ti-Al-Va).
  • [MeSH-major] Bone Neoplasms / surgery. Giant Cell Tumor of Bone / surgery. Histiocytoma, Benign Fibrous / surgery. Humerus / surgery. Joint Prosthesis. Sarcoma / surgery. Shoulder Joint / surgery
  • [MeSH-minor] Arthrodesis. Chondrosarcoma / surgery. Follow-Up Studies. Humans. Osteosarcoma / surgery. Prosthesis Failure. Sarcoma, Ewing / surgery. Time Factors

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  • (PMID = 12198947.001).
  • [ISSN] 0009-4749
  • [Journal-full-title] La Chirurgia degli organi di movimento
  • [ISO-abbreviation] Chir Organi Mov
  • [Language] eng; ita
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Italy
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22. Grünhagen DJ, de Wilt JH, Verhoef C, van Geel AN, Eggermont AM: TNF-based isolated limb perfusion in unresectable extremity desmoid tumours. Eur J Surg Oncol; 2005 Oct;31(8):912-6
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  • [Title] TNF-based isolated limb perfusion in unresectable extremity desmoid tumours.
  • BACKGROUND: Desmoid tumours are soft tissue sarcomas with local aggressive behaviour and a high rate of local recurrence after treatment.
  • Although they do not tend to metastasise systemically, the local aggressiveness can lead to situations in which limb-preserving surgery cannot be performed without severe disability.
  • As isolated limb perfusion (ILP) with TNF and melphalan has proven to be extremely effective in the treatment of soft tissue sarcoma, we studied its potential in locally advanced extremity desmoid tumours.
  • Local surgical therapy with preservation of limb function was impossible in all patients due to large or multifocal tumours, multiple recurrences or extensive previous treatment.
  • Perfusions were performed with 4-3mg TNF and 10-13 mg/l limb volume melphalan form leg and arm perfusions, respectively.
  • Local control was obtained after 10/12 ILPs and in the other two patients through repeat ILP and systemic chemotherapy, thus leading to an overall local control rate of 100%.
  • CONCLUSION: ILP is a very effective treatment option in the multimodality treatment of limb desmoid tumours.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Alkylating / administration & dosage. Chemotherapy, Cancer, Regional Perfusion. Dermoid Cyst / drug therapy. Lower Extremity / pathology. Melphalan / administration & dosage. Soft Tissue Neoplasms / drug therapy. Tumor Necrosis Factor-alpha / administration & dosage. Upper Extremity / pathology
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Disease Progression. Female. Humans. Limb Salvage. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Prospective Studies. Remission Induction. Treatment Outcome

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  • (PMID = 16098709.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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