[Monomelic thermochemotherapy for malignant melanoma of the limbs. Results of a homogeneous series of 128 patients].
Thermochemotherapy through regional CEC has been applied to malignant melanomas of the limbs for a long time as it was described by Creech and Krementz more than twenty years ago. Strangely enough, its application has remained confidential in France. In order to assess this method, we have been applying it to 128 consecutive patients from January 1, 1982 to January 1, 1990. After the exclusion of 9 patients (7 technical failures, 1 wrong diagnosis, 1 improper inclusion), the remaining series is of 119 patients for 125 infusions. The average distance in time is 3.4 years. The series includes 31 men and 88 women with an average age of 51.2 + 14.2 years (23-75) with malignant melanoma of the upper limb (25 cases) or lower limb (94 cases). The histological type of the tumor was nodular in 47 cases (39.5%), SSM in 40 cases (33.6%), acrolentiginous in 26 cases (22%) and undetermined in 6 cases (5%). All lesions were high-risk malignant melanomas for which Clark's index was higher than III and Breslow's index higher than 1.5 mm in 103 cases (16 cases in which Breslow's index ranged from 1 to 1.5 mm were included at the beginning of the series). Chemotherapy utilized Mephalan with a dose of 0.8 to 1.5 mg/kg of body weight, delivered through monomelic CEC and under hyperthermia at 41 degrees C during 45 to 50 minutes, via a cannulation of the axillary artery and vein in the upper limb and of the common femoral artery and vein in the lower limb.(ABSTRACT TRUNCATED AT 250 WORDS)
Kretz
J G
JG
Service de Chirurgie Cardiovasculaire, Chirurgie A, Hôpital Civil, Strasbourg.
Grosshans
E
E
Bartier
J C
JC
Chartier
C
C
Mantz
F
F
Chafke
N
N
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001132:Arm; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007866:Leg; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
D008558:Melphalan
Thermochimiothérapie monomélique pour mélanome malin des membres. Résultats d'une série homogène de 128 patients.