title: The role of regional hyperthermic cytostatic perfusion in the treatment of extremity melanoma.
abstract: To evaluate the effectiveness of regional hyperthermic cytostatic perfusion in patients with malignant melanomas of the extremities, 107 patients were included in a prospective randomized study. In a control group (A, n = 54) the tumors were widely excised, and the regional lymph nodes were dissected. The patients in the perfusion group (B, n = 53) received additional hyperthermic (42 degrees C) perfusion with melphalan. The disease-free survival time was chosen as the criterion for success. An intermediate evaluation (average follow-up observation period of 550 days) revealed a highly significant difference between the groups (P = 0.0001): 21 recurrences in the control group versus four recurrences in the perfusion group. In a second analysis 3 1/2 years after premature discontinuation, 26 recurrences were diagnosed in Group A, whereas only six recurrences were noted in Group B (P = 0.0001). A retrospective analysis of the entire test group revealed the following figures. In Group A seven recurrences in Stage I were diagnosed, seven in Stage II, and 12 in Stage III. In Group B one was observed in Stage I, one in Stage II, and four in Stage III. The level of significance was calculated to be P = 0.05 in Stage I, P = 0.05 in Stage II, and P = 0.01 in Stage III. The results of the study show that additional perfusion in the treatment of extremity melanomas is superior to conventional methods.
authors.affiliation: Department of Surgery, University of Cologne, West Germany.
authors.forename: F
authors.initials: F
authors.lastname: Ghussen
authors.forename: I
authors.initials: I
authors.lastname: Krüger
authors.forename: W
authors.initials: W
authors.lastname: Groth
authors.forename: H
authors.initials: H
authors.lastname: Stützer
mesh_terms: D001132:Arm; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007866:Leg; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008558:Melphalan / Q000627:therapeutic use*; D009367:Neoplasm Staging; D010477:Perfusion; D011446:Prospective Studies; D011897:Random Allocation; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*
chemical_list: D008558:Melphalan