Reynel et al. 2021 [298]
A 68-year-old patient from Peru underwent surgery for recurrent high-grade end-differentiated liposarcoma of the retroperitoneum (T2N0M0, FNCLCC grade 2, stage IIIA). Three months after this first surgery a recurrence occurred, which was treated neoadjuvantly and adjuvantly with doxorubicin plus ifosfamide and another surgery. A second recurrence – 11 months after the second surgery – was also excised and radiotherapy was started. Subcutaneous therapy with a Viscum album extract of ash mistletoe (VAE Fraxini) was then given at an injection frequency of three times per week, resulting in improved quality of life. A third recurrence – 12 months after the third surgery – was re-operated, radiotherapied and treated with a higher dose of mistletoe extract. At 5.8 years after the fourth surgery, a fourth recurrence occurred, which was excised again and treated with a one-month intravenous VAE infusion followed by subcutaneous VAE therapy. After the fifth recurrence, which occurred 5 months after the fifth surgery, subcutaneous and intravenous VAE applications and eribulin were administered. The patient died 11 months after the last recurrence. He received a total of 8.6 years of VAE treatment, which probably promoted this favourable outcome, and achieved a remarkable overall survival of 10.5 years.