title: Tumour response after hyperthermic isolated limb perfusion for locally advanced melanoma.
abstract: BACKGROUND
  The aim was to describe tumour response, complications, recurrence and survival after hyperthermic isolated limb perfusion (ILP) with melphalan or melphalan in combination with tumour necrosis factor-alpha in patients with melanoma metastases confined to an extremity.
  
  
  METHODS
  A total of 84 perfusions were performed (53 women, 31 men, median age 63 years) from 1993 to 2010. 95% of the perfusions were administered to the lower limbs and 5% to the upper limbs. The inclusion criteria were recurrent and/or clinically apparent cutaneous/subcutaneous extremity in-transit melanoma metastases.
  
  
  RESULTS
  The response rate after ILP was 85%; 42% had complete response (CR), 43% partial response (PR), 12% no change (NC) and 3% progression. Two- and five-year survival rates were 57% and 31%, respectively, and they were higher for patients with than without lymph node metastases. Time from ILP to recurrence was a median of seven months (range 1-37 months) for patients with CR or PR. Survival was longer for patients with CR or PR than for patients showing NC or progression. Several patients had mild or moderate local toxicity reactions, two patients developed severe local toxicity.
  
  
  CONCLUSIONS
  ILP induces tumour regression in the vast majority of patients. One patient, i.e. 1% of the group, died from surgical complications. Otherwise, ILP treatment had an acceptable morbidity in this group of very sick patients. We are convinced that the treatment should be offered to improve local disease control in patients with multiple and/or recurrent melanoma confined to an extremity if surgical excision is not possible.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Klinik for Plastikkirurgi, Brandsårsbehandling og Brystkirurgi, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. idafelbo@hotmail.com.
authors.forename: Ida Felbo
authors.initials: IF
authors.lastname: Paulsen
authors.forename: A H
authors.initials: AH
authors.lastname: Chakera
authors.forename: Jennifer Berg
authors.initials: JB
authors.lastname: Drejøe
authors.forename: Helle
authors.initials: H
authors.lastname: Klyver
authors.forename: Karin
authors.initials: K
authors.lastname: Dahlstrøm
authors.forename: Peter Sandor
authors.initials: PS
authors.lastname: Oturai
authors.forename: Jann
authors.initials: J
authors.lastname: Mortensen
authors.forename: Birger
authors.initials: B
authors.lastname: Hesse
authors.forename: Grethe
authors.initials: G
authors.lastname: Schmidt
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Drzewiecki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D003131:Combined Modality Therapy; D018450:Disease Progression; D005121:Extremities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D014409:Tumor Necrosis Factor-alpha; D008558:Melphalan