BACKGROUND: In order to reduce the systemic toxity of cisplatin and to incr
ease the effect on the local tumor, facilitating limb-preserving procedures
, we have been using hyperthermic isolated regional perfusion (HIRP) for th
e treatment of osteosarcoma in addition to preoperative chemotherapy.
MATERIALS AND METHODS: Twenty patients with an osteosarcoma in a lower extr
emity were treated with both preoperative chemotherapy and HIRP.
RESULTS: The chemotherapeutic effects of preoperative chemotherapy with HIR
P was grade III in 6, and grade IV (no viable cell areas observed) in 7. Th
e surgical margins could be reduced in these 13 cases of good responders sh
owing over 90% necrosis (grade III or grade IV), which mainly involved post
necrotic fibrosis and osteosclerosis.
CONCLUSION: HIRP can help to control the tumor locally. A more conservative
operation was then possible in cases of good responders to preoperative ch
emotherapy with HIRP. Am J Surg. 1999;178:27-32. (C) 1999 by Excerpta Medic