A single centre's 10 year experience with isolated limb perfusion in the treatment of recurrent malignant melanoma of the limb

Management of Extremity Recurrences After Complete Responses to Isolated Limb Perfusion in Patients With Melanoma

“…[3][4][5] Although reported CR rates are high, ranging from 60% to 90%, [5][6][7][8] limited data are available on longterm outcomes for these patients, and extremity recurrence seems common. 7 When extremity recurrence occurs as the first site of failure after the CR to ILP, management options include local excision, repeat ILP, various systemic methods (including chemotherapy and/or immunotherapy), and very rarely amputation.…”

“…[3][4][5] This approach to delivering high regional doses of chemotherapeutic agents to the involved extremity while avoiding serious systemic toxicity has yielded response rates up to 100%, with complete response (CR) rates ranging from 60% to 90%. [5][6][7][8] Unfortunately, despite the high CR rates after ILP, extremity recurrence occurs in 22-100% of patients in reported series. 7 Although ILP has been shown to be an efficacious method for rendering patients with extremity melanoma clinically free of disease, the optimal strategy for treating locoregional recurrences after CRs to ILP remains undefined.…”

Prognostic Scoring in Patients With Melanoma After Adjuvant Isolated Limb Perfusion

“…The perfusion was performed for 60 min. The technique of ILP has been described previously [8,9]. The adverse effects were similar to other reported series and there was no procedural related mortality [10,11].…”

Current status of isolated limb infusion with mild hyperthermia for melanoma

“…In about 50% of patients the primary disease is located on an extremity [2]. The risk of recurrence after definitive resection of the primary tumour is related primarily to the Breslow thickness of the lesion but is also influenced by other variables such as tumour ulceration and mitotic rate, which are independent predictors of recurrence [2].…”

“…In about 50% of patients the primary disease is located on an extremity [2]. The risk of recurrence after definitive resection of the primary tumour is related primarily to the Breslow thickness of the lesion but is also influenced by other variables such as tumour ulceration and mitotic rate, which are independent predictors of recurrence [2]. The literature indicates that 6-19% of patients with American Joint Committee on Cancer (AJCC) Stage II melanomas that are 41.5mm thick and are located on an extremity develop 'in-transit' metastases, due to spread of the tumour through intradermal or subcutaneous lymphatics [3].…”