• Martin K Angele, Markus Albertsmeier, Niclas J Prix, Peter Hohenberger, Sultan Abdel-Rahman, Nelli Dieterle, Michael Schmidt, Ulrich Mansmann, Christiane J Bruns, Rolf D Issels, Karl-Walter Jauch, and Lars H Lindner.
• *Department of General, Visceral, Transplantation, Vascular, and Thoracic Surgery and †Department of Internal Medicine III, University of Munich-Campus Grosshadern, Munich, Germany ‡Sarcoma Unit ITM-Interdisciplinary Tumor Center Mannheim, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany §Institute of Medical Informatics, Biometry, and Epidemiology, University of Munich-Campus Großhadern, Munich, Germany ¶Department of General, Visceral, and Vascular Surgery, University Hospital Magdeburg, University of Magdeburg, Magdeburg, Germany.
• Ann. Surg.. 2014 Nov 1;260(5):749-54; discussion 754-6.

ObjectiveTo determine whether regional hyperthermia (RHT) in addition to chemotherapy improves local tumor control after macroscopically complete resection of abdominal or retroperitoneal high-risk sarcomas.BackgroundWithin the prospectively randomized EORTC 62961 phase-III trial, RHT and systemic chemotherapy significantly improved local progression-free survival (LPFS) and disease-free survival (DFS) in patients with abdominal and extremity sarcomas. That trial included macroscopically complete and R2 resections.MethodsA subgroup analysis of the EORTC trial was performed and long-term survival determined. From 341 patients, 149 (median age 52 years, 18-69) were identified with macroscopic complete resection (R0, R1) of abdominal and retroperitoneal soft-tissue sarcomas (median diameter 10 cm, G2 48.3%, G3 51.7%). Seventy-six patients were treated with EIA (etoposide, ifosfamide, doxorubicin)+RHT (≥5 cycles: 69.7%) versus 73 patients receiving EIA alone (≥5 cycles: 52.1%, P=0.027). LPFS and DFS as well as overall survival were determined.ResultsRHT and systemic chemotherapy significantly improved LPFS (56% vs 45% after 5 years, P=0.044) and DFS (34% vs 27% after 5 years, P=0.040). Overall survival was not significantly improved in the RHT group (57% vs 55% after 5 years, P=0.82). Perioperative morbidity and mortality were not significantly different between groups.ConclusionsIn patients with macroscopically complete tumor resection, RHT in addition to chemotherapy resulted in significantly improved local tumor control and DFS without increasing surgical complications. Within a multimodal therapeutic concept for abdominal and retroperitoneal high-risk sarcomas, RHT is a treatment option beside radical surgery and should be further evaluated in future trials.

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