Evaluation of chemotherapy of cancer by regional perfusion

Abstract

At Tulane Department of Surgery 597 patients with cancer have been perfused regionally 690 times—350 patients with melanoma, 164 with carcinoma and 83 with sarcoma. Early objective responses were noted in about 70% of patients with melanoma and in 60% with carcinoma and sarcoma. The duration of response in many instances was short whereas the expenditure of operating time and medical manpower was large. In poor‐risk patients with advanced disease the mortality rate was appreciable. In some patients, however, perfusion offered more than conventional therapy and is a valuable technique. In secondary melanoma—involvement of regional nodes, satellitosis or local recurrence—control has been obtained in 10 of 38 patients five years after perfusion. In primary melanoma confined to a limb the disease has been controlled in 10 of 11 patients five years after perfusion, conservative excision and node dissection. In sarcoma confined to the limbs perfusion and wide excision produced control of disease in 10 of 14 patients at five years. Perfusion as an adjunct to excision in patients with carcinoma adds little. Good palliation has been obtained in patients with a variety of malignant tumors by control of primary disease, even in the presence of systemic metastases.