title: [Isolated hyperthermic antiblastic perfusion in recurrent melanoma of the extremities].
abstract: Twenty-two patients with recurrent melanoma of the limbs, underwent Hyperthermic Antiblastic Perfusion (HAP). HAP lasted 60 min, with maximal local temperature of 40.5-42 degrees C and melphalan 10 mg/L limb volume as antiblastic agent. Fourteen patients had in-transit metastases and 8 local recurrences. Regional nodes were involved in 6 patients. Systemic leakage monitored with 125I or 99Tc ranged between 5 and 30% (mean 19%). No operative mortality nor major complications occurred. Local toxicity scored Wieberdink grade I in 6 patients, grade II in 11 and III in 5. Response rate (UICC) in the 9 patients treated with unexcised lesions was 88% (55% complete responses). After a median follow-up of 27 months (1-92) 9 patients relapsed after a median time of 17 months, and 15 patients are currently disease free, 4 of them being re-excised and one reperfused. Actuarial 5 year survival is 67%, with 45% disease free to the first relapse. Our results are consistent with the literature indicating HAP as a safe procedure with a high evidence of clinical responses.
authors.affiliation: Istituto di Clinica Chirurgica e Terapi Chirurgica I, Università degli Studi di Genova.
authors.forename: F
authors.initials: F
authors.lastname: De Cian
authors.forename: M L
authors.initials: ML
authors.lastname: Rainero
authors.forename: G
authors.initials: G
authors.lastname: Mondini
authors.forename: C
authors.initials: C
authors.lastname: Spirito
authors.forename: G
authors.initials: G
authors.lastname: D'Addazio
authors.forename: G A
authors.initials: GA
authors.lastname: Simoni
authors.forename: D
authors.initials: D
authors.lastname: Civalleri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D005334:Fever; D006801:Humans; D007866:Leg; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010477:Perfusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
vernacular_title: La perfusione isolata ipertermico-antiblastica nel melanoma recidivo degli arti.