Adjuvant regional isolated perfusion with melphalan for patients with Clark V melanoma of the extremities.
From 1978 to 1990, 32 patients with Clark V melanoma were treated by wide excision of the primary and adjuvant regional isolated perfusion with melphalan. M.D. Anderson stage of disease was stage I in 22 and stage IIIb in 10 patients. Five-year survival rates were 58% and 27%, respectively. Seven patients developed a recurrence in the perfused limb [stage I, 2, stage IIIb, 5 patients (P = 0.03)], and 4 of 17 patients developed regional lymph node metastases. Of the well-known prognostic variables, only ulceration of the primary tumor significantly influenced survival (P = 0.03). We did not see any improvement in survival rates compared with literature data on nonperfused patients. In the absence of data on locoregional recurrence rates in nonperfused Clark V melanoma patients, we cannot say whether adjuvant perfusion diminished this risk. Therefore, the results of the prospective randomized EORTC/WHO trial in primary high-risk extremity melanoma have to be awaited.
Vrouenraets
B C
BC
Department of Surgery, The Netherlands Cancer Institute (Antoni Van Leeuwenhoek Huis), Amsterdam.
Kroon
B B
BB
Klaase
J M
JM
Van Geel
B N
BN
Eggermont
A M
AM
Franklin
H R
HR
D000328:Adult; D000368:Aged; D010478:Chemotherapy, Cancer, Regional Perfusion; D005069:Evaluation Studies as Topic; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
D008558:Melphalan