The role of hyperthermic perfusion in the treatment of tumors of the extremities.

Approximately 60% of all soft tissue and osteogenic sarcomas and 50% of all melanomas arise in the extremities. Treatment of these tumors has traditionally been limited to local surgical procedures, often resulting in a non-functioning limb or amputation, particularly in the case of sarcoma and in a local recurrence rate Primarily related to the biological tumor aggressiveness. A higi incidence of micrometastatic nodules has been found in most high-grade sarcomas and in high-risk melanomas in the form of “skip” or “in transit” metastases. This suggests that these tumors cannot be managed as locally confined neoplasms, being a regional disease “ab initio” and requiring loco-regional treatment.