Prophylactic isolated limb perfusion for localized, high-risk limb melanoma: results of a multicenter randomized phase III trial. European Organization for Research and Treatment of Cancer Malignant Melanoma Cooperative Group Protocol 18832, the World Health Organization Melanoma Program Trial 15, and the North American Perfusion Group Southwest Oncology Group-8593.

Koops, H. Schraffordt; Vaglini, M.; Suciu, Stefan; Kroon, Bin B. R.; Thompson, John F.; Göhl, J.; Eggermont, Alexander; Filippo, F. Di; Krementz, Edward T.; Ruiter, Dirk J.; Lejeune, Ferdy J.

doi:10.1200/jco.1998.16.9.2906

Cited by 220 publications

(60 citation statements)

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“…Isolated limb perfusion (ILP) is an attractive treatment modality for multiple melanoma in-transit metastases 12,13 . Melphalan is used as the standard chemotherapeutic drug in ILP, with complete response rates of 40-50 per cent 14 ; however, response rates of bulky melanoma lesions have been disappointing owing to poor drug uptake by the tumour, similar to results for advanced soft tissue sarcomas 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Long-term outcome of isolated limb perfusion with tumour necrosis factor-α for patients with melanoma in-transit metastases

Deroose

Grünhagen

Geel

et al. 2011

British Journal of Surgery

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Section: Introductionmentioning

confidence: 99%

Long-term outcome of isolated limb perfusion with tumour necrosis factor-α for patients with melanoma in-transit metastases

Deroose

Grünhagen

Geel

et al. 2011

British Journal of Surgery

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“…The authors of this cooperative study group concluded that prophylactic isolated limb perfusion with melphalan could not be recommended as standard therapy for high-risk primary melanoma of the extremities [370].…”

Section: A Hauschildmentioning

confidence: 99%

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Pflugfelder

Kochs

Blum

et al. 2013

J Deutsche Derma Gesell

181

148

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“…The largest adjuvant study on local hyperthermic limb perfusion with melphalane was a project of the North American Perfusion Group (NAPG), the EORTC, and the WHO. The results showed a decreased incidence of locoregional metastasis but no OS benefit compared to the control group [31]. This treatment with a high toxicity should be restricted to non-resectable in-transit metastasis and not be used as an adjuvant therapy anymore.…”

Section: Hyperthermic Limb Perfusionmentioning

confidence: 92%

Adjuvant Therapy in Melanoma

Mohr

Weichenthal²,

Hauschild³

2003

Oncol Res Treat

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Despite intensive research and numerous clinical trials on the adjuvant treatment of patients with high-risk cutaneous melanoma, the issue is still controversial. Early positive results from studies on adjuvant chemo- and immunotherapy were based on historical controls and could not be confirmed by prospective randomized trials. The effect of interleukin-2 in the adjuvant treatment of malignant melanoma is not yet clearly defined. Combined treatment modalities like bio-chemotherapy are still to be analyzed in controlled clinical trials, and results of new studies with active specific immunization (vaccination) will only be available within the next years. Only interferon alpha (IFN α) has shown reproducible superiority over observation for high-risk melanoma patients in large prospective randomized trials with respect to disease-free survival (DFS) and partially for overall survival (OS). These studies resulted in the approval of IFN α for the adjuvant treatment of malignant melanoma in many countries. Low-dose IFN has shown significant prolongation of DFS, but so far failed to improve OS. The question whether high-dose IFN has shown enough superiority over observation with respect to OS based on one negative and two positive trials to make it the standard therapy in stage IIb,c and stage III melanoma patients still remains unanswered. Results from intermediate-dose IFN α, pegylated IFN α, and modified high-dose interferon schedules are pending. In conclusion, interferon is the cornerstone of adjuvant therapy in high-risk melanoma today, but the optimal dosage and duration of treatment are still to be defined. Patients with high-risk malignant melanoma should preferentially be treated in prospective randomized multicenter trials to give more detailed data for treatment recommendations.

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Abstract: Prophylactic ILP with melphalan cannot be recommended as an adjunct to standard surgery in high-risk primary limb melanoma.

Cited by 220 publications

References 21 publications

Long-term outcome of isolated limb perfusion with tumour necrosis factor-α for patients with melanoma in-transit metastases

Long-term outcome of isolated limb perfusion with tumour necrosis factor-α for patients with melanoma in-transit metastases

Malignant Melanoma S3‐Guideline “Diagnosis, Therapy and Follow‐up of Melanoma”

Adjuvant Therapy in Melanoma

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