The use of isolated limb perfusion to manage recurrent malignant melanoma.
Hyperthermic isolated limb perfusion (ILP) effectively treats locally recurrent metastatic disease in malignant melanoma of the extremities. The goal of ILP is to decrease the rate of further recurrent disease and eradicate tumor load to achieve wound hygiene and preservation of limb function. This article reviews the development over the last 45 years of ILP in the treatment of malignant melanoma, describes the surgical technique of ILP, and reviews the results of clinical trials with various chemotherapeutic agents. It discusses the recent addition of tumor necrosis factor alpha to the list of drugs currently being explored in hyperthermic ILP, in the ongoing attempt to improve the treatment for recurrent malignant melanoma of the extremities.
Ma
D
D
Yale Melanoma Unit, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Ariyan
S
S
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects / Q000379:methods; D005121:Extremities; D006801:Humans; D006979:Hyperthermia, Induced; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014409:Tumor Necrosis Factor-alpha