A Retrospective Study of Regional Perfusion for Melanoma

Wagner, Donald E.

doi:10.1001/archsurg.1976.01360220106017

Cited by 25 publications

(7 citation statements)

References 5 publications

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“…38 Wagner reported a local recurrence rate of 3.2% under similar conditions. 39 Four years ago, a new modification of limb perfusion technique, combining the use of cytokines with chemotherapy, was introduced by Lienard and colleagues at the Jules Bordeau Institute in Brussels, Belgium.40 Isolated hyperthermic limb perfusion with melphalan was combined with recombinant tumor necrosis factor (rTNF)-a and recombinant interferon (rIFN)-a. It was soon learned that fluid loading and dopamine infusion of 3 yg/kg/min, starting before administration of rTNF-a and continuing for 48 hours after the perfusion, was required to prevent morbidity and mortality from capillary leak syndrome.…”

Section: Complicationsmentioning

confidence: 99%

Regional Chemotherapy for Melanoma A 35-Year Experience

et al. 1994

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ObjectiveThe authors present their 35-year experience with intra-arterial chemotherapeutic regionai perfusion of 1 139 patients with melanomas, using an extracorporeal oxygenated circuft and heart-lung apparatus. Summary Background DataIntra-arterial chemotherapy produces improved responses in many tumors. By isolating and sustaining the area with extracorporeal oxygenated circulation, high doses can be delivered to the tumor area, limited only by local toxicity. Drug levels up to 10 times those achieved by systemic administration are obtained. MethodsTechniques for hyperthermic perfusion were developed for limbs, pelvis, head, neck, and skin of the breast. Melphalan (Burroughs Wellcome, Research Triangle Park, NC) was used in 753 patients. Combinations with melphalan or other drugs were used in remaining cases at temperature of 38 to 40 C for 30 to 60 minutes. ResultsChemotherapy perfusion followed by tumor excision or node dissection, was performed where indicated. The cumulative 1 0-year survival for patients with localized melanomas was 70%. For patients with local recurrences or satellites within 3 cm, survival was 61 %. For those with regionally confined intransit tumors, survival was 30%; for those with regional node involvement, 38%; for those with intransit and nodal metastases, 16%; for those with distant metastases and perfusion-mainly to save functional limbs-survival was 7%. Multiple perfusions were performed in 158 patients with recurrent disease on 366 occasions. Patients with indolent regionally confined melanomas were benefited by prolongation of useful life. ConclusionsSafe perfusion techniques are available for most anatomic regions. Increased chemotherapeutic doses are delivered to isolated areas limited only by local toxicity. Adjunct perfusion in poor prognosis stage cases is useful in reducing local recurrence, and intransit or lymph node metastases. Regional perfusion reduces the need for major amputation. Multiple perfusion can be useful in treating recurrent chronic melanoma. 520

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Section: Complicationsmentioning

confidence: 99%

Regional Chemotherapy for Melanoma A 35-Year Experience

et al. 1994

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“…Fontaine and Jamieson (1974) reported a series of 56 patients with malignant melanomas of limbs treated by surgery and perfusion with phenylalanine mustard in which the five‐year survival rate was 67%. Wagner (1976) reported on a series of 245 patients with malignant melanoma treated by regional perfusion with phenylalanine mustard in whom regional perfusion improved cure rates of conventional surgery by at least 10–15%. In another series, excision of the primary lesion and isolation‐perfusion with phenylalanine mustard was the treatment in 199 patients with invasive Stage I malignant melanoma of the extremities.…”

Section: Section 18bmentioning

confidence: 99%

Malignant Melanoma: A Review

Kopf

Bart

Rodríguez-Sains

1977

The Journal of Dermatologic Surgery and Oncology

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“…A subsequent study yielded similar conclusions, and showed that death from recurrent or disseminated disease after initial perfusion therapy occurred with greatest frequency within 24 months 5 . Detailed studies of the perfusion technique, complications post perfusion, and results of therapy are presented by Krementz and Ryan, 5 Stehlin et al, 6 and Wagner 7 . Stehlin 8 reported relatively high 5‐year survival rates after the use of heated perfusion therapy.…”

Section: Discussionmentioning

confidence: 81%

Multiple Cutaneous Melanoma Metastases of an Extremity Resembling Kaposi's Sarcoma: Use of Regional Perfusion

Lancer

Bronstein

Sober

1984

The Journal of Dermatologic Surgery and Oncology

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We report on a patient with primary cutaneous malignant melanoma, with numerous intransit metastases involving the left lower extremity. The clinical presentation was striking in that the intransit metastatic lesions of the skin had morphologic characteristics of Kaposi's sarcoma. Her disease was complicated by marked lower limb edema. Cutaneous ulceration did not develop despite the extensive tumor burden. Treatment with regional limb perfusion resulted in marked reduction of the edema and shrinkage of the tumor mass. In addition to presenting this case report and response to therapy, we would like to suggest the term "chronic melanoma of the extremity" (CME) as a descriptive term for this unusual variant of malignant melanoma.

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A Retrospective Study of Regional Perfusion for Melanoma

Cited by 25 publications

References 5 publications

Regional Chemotherapy for Melanoma A 35-Year Experience

Regional Chemotherapy for Melanoma A 35-Year Experience

Malignant Melanoma: A Review

Multiple Cutaneous Melanoma Metastases of an Extremity Resembling Kaposi's Sarcoma: Use of Regional Perfusion

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