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Retinoblastoma eyes with choroidal invasion may not have to be enucleated and may be successfully managed with OAC using Melphalan, Carboplatin and Topotecan without compromising patient survival.

Fifteen patients with large (average, 15-cm), high-grade soft-tissue sarcomas of the extremities received prolonged selective intraarterial infusions of chemotherapeutic agents in an attempt to permit limb-sparing resection of these tumors, which would otherwise have required amputation. There were seven malignant fibrous histiocytomas, four liposarcomas, two fibrosarcomas, one leiomyosarcoma, and one rhabdomyosarcoma; 73% were grade III. Seven patients underwent two catheterizations, for a total of 22 infusions, which averaged 11.3 days each. There were four catheterization-related complications, including catheter occlusion or dislodgement in one patient each and two cases of arterial thromboembolism in patients in whom anticoagulant dose was not adequate. Both of the latter patients required thrombectomy; one developed gangrene, which precluded limb-sparing surgery. Thirteen of the 15 patients underwent limb-sparing resections, and two underwent amputations. No wound complications occurred. With a median follow-up of 36 months (mean, 34 months), life-table analysis indicates overall and disease-free survivals of 72% and 59%, respectively, at 2 years and 64% and 59% at 3 years. In comparison to other reported therapies, this technique permits limb salvage in most patients without the high wound complication rate associated with preoperative radiation therapy, with equivalent local disease control and survival.

To improve the results of surgery in the treatment of liver metastases the following strategies are under investigation: 1. Adjuvant systemic and regional chemotherapy to eliminate micrometastases 2. Preoperative intraarterial chemotherapy to improve resectability and to avoid intraoperative tumour cell propagation 3. Intraoperative sonography as well to improve the definition of adequate resection margins as to detect additional metastases 4. Radio-Immuno-Guided Surgery (RIGS) or Laser-Induced-Fluorescence-Diagnosis (LIFD) to improve the intraoperative detection of micrometastases and of extrahepatic tumour manifestations 5. Laser-Induced-Hyperthermia (LIT) or cryotherapy to treat irresectable metastases 6. In situ or ex situ liver perfusion (work bench technique) to treat multiple liver metastases 7. Tumour cell vaccination to treat colorectal micrometastases. These strategies will have to be approved in further, carefully planned clinical investigations. There is hope that at least some of these concepts will add to a stepwise improvement of the results of surgical therapy in patients with colorectal liver metastases.

The successful application of radiolabeled antibodies in diagnosis and therapy of human diseases is the final result of a long and intimate cooperation and collaboration between at least four scientific branches: immunology, radiochemistry/biology, oncology, and nuclear medicine (Table 1/ Figure 1).