Ten hyperthermic isolation-perfusions with melphalan were performed for invasive malignant melanoma of the limbs. Four cases at stage II and with in transit metastases (up to 15 cm in diameter) had a complete regression. However, no improvement of survival was noticed: 4 out of 5 stage II patients who died, within 1 year after perfusion, developed a generalized disease. Systemic chemotherapy was administered in 3 patients after perfusion, but they died from distant metastases. The need for an adequate adjuvant treatment added to isolation perfusion is discussed.
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References
1.
BergelF., StockJ. A.: Cytotoxic alpha amino-acids and peptides. 31st Ann. Rep. British Empire Cancer Campain, p. 6, 1953.
2.
CreechO.Jr., KrementzE.T., RyanR. F., WinbladJ. N.: Chemotherapy for cancer. Regional perfusion utilizing an extracorporeal circuit. Ann Surg., 148: 616, 632, 1958.
3.
De WaschG., BernheimJ., MichelJ., LejeuneF., KenisY.: Combination chemotherapy with 3 marginally effective agents, CCNU, vincristine and bleomycin, in the treatment of stage III melanoma. Cancer Treat. Rep., 60: 1273–1276, 1976.
4.
KrementzE. T., KnudsonL.: The effect of increased oxygen tension on the tumoricidal effect of nitrogen mustard. Surgery, 50: 266–273, 1961.
5.
KrementzE. T., RyanR. F.: Chemotherapy of melanoma of the extremities by perfusion: Fourteen years clinical experience. Ann. Surg., 175: 900–917, 1972.
LebrunJ., SmetsW.: La perfusion régionale par circulation extra-corporelle. Technique chirurgicale permettant l'administration d'agents chimiothérapiques anti-cancéreux à doses élevées. Acta Chir. Belg., 60: 368–405, 1961.
8.
MatheG., KenisY.: Les cancers cutanés et le mélanome malin. pp. 415–423. In: La Chimiothérapie des Cancers.Expansion Scientifique Française, Paris, 1975.
9.
Mc BrideC. M., ClarkR. L.: Experience with I-phenylalanine mustard dihydrochloride in isolation perfusion of extremities for malignant melanoma. Cancer, 28: 1293–1296, 1971.
10.
Mc BrideC. M., SugarbakerE. V., HickeyR. C.: Prophylactic isolation perfusion as the primary therapy for invasive malignant melanoma of the limbs. Ann. Surg., 182: 316–324, 1975.
11.
RochlinD. B., SmartC. R.: Treatment of malignant melanoma by regional perfusion. Cancer, 18: 1544–1550, 1965.
12.
Schraffordt-KoopsH., OldhoffJ., Van der PloegE., VermeyA., EiberyenR.: Isolated regional perfusion in the treatment of malignant melanomas of the extremities. Arch. Chir. Neerl., 27: 237–243, 1975.
13.
ShingletonW. W.: Perfusion chemotherapy for recurrent melanoma of extremity: A progress report. Ann. Surg., 169: 969–973, 1969.
14.
StehlinJ. S.Jr., ClarkR. L.: Melanoma of the extremities; experiences with conventional treatment and perfusion in 339 cases. Am. J. Surg., 110: 366–383, 1965.
15.
StehlinJ. S.Jr., GiovanellaB. C., de IpolyiP. D., MuenzL. R., AndersonR. F.: Results of hyperthermic perfusion for melanoma of the extremities. Surg. Gynec. Obstet., 140: 338–348, 1975.
16.
WeaverP. C., WrightJ., BranderW. L., WestburyG.: Salvage procedures for locally advanced malignant melanoma of the lower limb (with special reference to the role of isolated limb perfusion and radical lymphadenectomy). Clin. Oncol., 1: 45–51, 1975.