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Schellerer VS, Frenger J, Merkel S, et al. Results of isolated limb perfusion for metastasized malignant melanoma. Surg Oncol. 2021;38:101603doi: 10.1016/j.suronc.2021.101603.
Schellerer, V. S., Frenger, J., Merkel, S., Goehl, J., Kersting, S., Gruetzmann, R., Erdmann, M., & Foertsch, T. (2021). Results of isolated limb perfusion for metastasized malignant melanoma. Surgical oncology, 38101603. https://doi.org/10.1016/j.suronc.2021.101603
Schellerer, Vera S, et al. "Results of isolated limb perfusion for metastasized malignant melanoma." Surgical oncology vol. 38 (2021): 101603. doi: https://doi.org/10.1016/j.suronc.2021.101603
Schellerer VS, Frenger J, Merkel S, Goehl J, Kersting S, Gruetzmann R, Erdmann M, Foertsch T. Results of isolated limb perfusion for metastasized malignant melanoma. Surg Oncol. 2021 Sep;38:101603. doi: 10.1016/j.suronc.2021.101603. Epub 2021 May 08. PMID: 33992896.
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Surg Oncol. 2021 Sep;38:101603. doi: 10.1016/j.suronc.2021.101603. Epub 2021 May 08.

Results of isolated limb perfusion for metastasized malignant melanoma.

Surgical oncology

Vera S Schellerer, Johannes Frenger, Susanne Merkel, Jonas Goehl, Stephan Kersting, Robert Gruetzmann, Michael Erdmann, Thomas Foertsch

Affiliations

  1. Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany. Electronic address: [email protected].
  2. Department of Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
  3. Department of Surgery, Universitätsmedizin Greifswald, Greifswald, Germany.
  4. Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054, Erlangen, Germany.

PMID: 33992896 DOI: 10.1016/j.suronc.2021.101603

Abstract

BACKGROUND AND OBJECTIVES: Locoregional metastases are typical biological manifestations of advanced malignant melanomas. Treatment with hyperthermic isolated limb perfusion (HILP) should be considered in affected patients. In the present study, we have analyzed the results of HILPs performed in our department.

PATIENTS AND METHODS: Eighty patients with locoregional metastases of the extremities received HILP at the Department of Surgery between January 2007 and December 2016. The mean follow-up was 38 months.

RESULTS: The study included 50 men and 30 women (mean age: 63 years). The median time between melanoma diagnosis and HILP was 25 months (range: 1-219 months). HILP was performed in curative (n = 45) and palliative (n = 35) intention. Seventy-five patients received a drug combination of melphalan/dactinomycin and five patients received a drug combination of melphalan/tumor necrosis factor-alpha. Remission rates were determined in 72 of 80 patients (90%) as follows: partial response n = 28, complete response n = 25, no response n = 19. Of the 25 patients with complete response, 13 patients developed a new tumor manifestation during follow-up (locoregional recurrences n = 4; distant metastases n = 3; both n = 6). The median overall survival rate was 33 months. Tumor stage influenced the survival rate significantly (p = 0.001). Patients with complete response showed a significantly better overall survival than patients with partial or no response (p = 0.016).

CONCLUSION: HILP is an effective therapeutic option in patients with locoregional metastases. This procedure carries a certain risk of side effects and adverse events but overall results in good response rates. Therefore, HILP should be offered to selected patients based on an individual discussion, considering their health status and oncological prognosis.

Copyright © 2021. Published by Elsevier Ltd.

Keywords: Hyperthermic isolated limb perfusion; In-transit metastases; Malignant melanoma; Recurrence; Survival

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