Initial experiences with isolated limb perfusion for unresectable melanoma of the limb

• Published in: Irish journal of medical science 2011-06, Vol.180 (2), p.517-520
• Main Authors: Romics, L., Dy, E. A., Coffey, J. C., Herlihy, D., Aftab, F., Chaudhry, M. Z., Fogarty, K., O’Donnell, J. A., Redmond, H. P.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy, Cancer, Regional Perfusion - adverse effects; Family Medicine; Female; General Practice; Humans; Internal Medicine; Lower Extremity; Male; Medicine; Medicine & Public Health; Melanoma - drug therapy; Melanoma - secondary; Melphalan - administration & dosage; Middle Aged; Neoplasm Recurrence, Local; Original Article; Retrospective Studies; Skin Neoplasms - drug therapy; Treatment Outcome; Tumor Necrosis Factor-alpha - administration & dosage; Upper Extremity
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-010-0664-2

Aims Our initial results with isolated limb perfusion (ILP) using melphalan ± TNF alpha in patients with unresectable melanoma of the limb were analyzed. Methods 15 ILPs were performed between 2001 and 2006. Indications for ILP were stage III or IV metastatic melanoma. Complete and partial response rates, time to local and systemic tumour progression rates, disease free and overall survival rates were retrospectively analyzed. Results Overall response rate was 93%, with a 67% complete response and a 26% partial response rate. In eight cases grade II, while in six cases grade III local toxicity was detected. However, one mortality was detected in the early postoperative phase due to a grade V complication. With a mean follow-up period of 2.7 years, eight patients had local progression and in four of those, systemic progression was detected. Conclusions ILP was generally well tolerated and limb salvage was achieved in all cases.