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Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma.

Publication ,  Journal Article
Brobeil, A; Berman, C; Cruse, CW; De Conti, R; Cantor, A; Lyman, GH; Joseph, E; Rapaport, D; Wells, K; Reintgen, DS
Published in: Ann Surg Oncol
June 1998

BACKGROUND: Recurrent melanoma of the extremity has been treated by local excision, systemic chemotherapy, amputation, or a combination of these approaches. Hyperthermic isolated limb perfusion (HILP) provides a method of limb preservation through isolation, allowing the administration of chemotherapy in higher doses than is possible through systemic treatment. METHODS: An experimental group of 59 HILP patients with melanoma recurrences of the extremity was studied prospectively. A control group of 248 melanoma patients with similar recurrences was excluded from HILP because their recurrences were in non-extremity locations. The experimental group underwent HILP and excision; the control group had excision only. The experimental procedure consisted of vascular isolation of the affected extremity and a 1-hour perfusion with melphalan. Temperatures were maintained at 40 degrees C in the perfusion circuit. RESULTS: The HILP patients had a lower rate of locoregional recurrence (P=.028) and demonstrated increased survival (P=.026) compared to the control group. In multivariate regression analysis, which included age, ulceration and thickness of the primary, and the treatment variable of perfusion, age (P=.02) and perfusion for the treatment of recurrence (P=.006) were significant predictors of survival. CONCLUSIONS: HILP improves prognosis by sterilizing the treated extremity, controlling locoregional disease, and perhaps preventing metastasis, thus having a positive impact on overall survival.

Duke Scholars

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

June 1998

Volume

5

Issue

4

Start / End Page

376 / 383

Location

United States

Related Subject Headings

  • Survival Analysis
  • Prospective Studies
  • Perfusion
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Multivariate Analysis
  • Middle Aged
  • Melanoma
  • Male
  • Hyperthermia, Induced
 

Citation

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Chicago
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MLA
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Brobeil, A., Berman, C., Cruse, C. W., De Conti, R., Cantor, A., Lyman, G. H., … Reintgen, D. S. (1998). Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma. Ann Surg Oncol, 5(4), 376–383. https://doi.org/10.1007/BF02303503
Brobeil, A., C. Berman, C. W. Cruse, R. De Conti, A. Cantor, G. H. Lyman, E. Joseph, D. Rapaport, K. Wells, and D. S. Reintgen. “Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma.Ann Surg Oncol 5, no. 4 (June 1998): 376–83. https://doi.org/10.1007/BF02303503.
Brobeil A, Berman C, Cruse CW, De Conti R, Cantor A, Lyman GH, et al. Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma. Ann Surg Oncol. 1998 Jun;5(4):376–83.
Brobeil, A., et al. “Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma.Ann Surg Oncol, vol. 5, no. 4, June 1998, pp. 376–83. Pubmed, doi:10.1007/BF02303503.
Brobeil A, Berman C, Cruse CW, De Conti R, Cantor A, Lyman GH, Joseph E, Rapaport D, Wells K, Reintgen DS. Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma. Ann Surg Oncol. 1998 Jun;5(4):376–383.
Journal cover image

Published In

Ann Surg Oncol

DOI

ISSN

1068-9265

Publication Date

June 1998

Volume

5

Issue

4

Start / End Page

376 / 383

Location

United States

Related Subject Headings

  • Survival Analysis
  • Prospective Studies
  • Perfusion
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Multivariate Analysis
  • Middle Aged
  • Melanoma
  • Male
  • Hyperthermia, Induced