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Survival and regional disease control after isolation‐perfusion for invasive stage I melanoma of the extremities
Author(s) -
Sugarbaker Everett V.,
McBride Charles M.
Publication year - 1976
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197601)37:1<188::aid-cncr2820370127>3.0.co;2-s
Subject(s) - medicine , perfusion , melanoma , subclinical infection , surgery , stage (stratigraphy) , lymph , disease , pathology , paleontology , cancer research , biology
Excision of the primary and isolation‐perfusion with 1‐phenylalanine mustard was the treatment in 199 patients with invasive Stage I melanoma of the extremities with the goal of improving regional disease control and long‐term survival. The determinant survival in patients followed 5–15 years was 83%; Berkson‐Gage survivals were 98% at 2 years, 88% at 5 years, and 84% at 10 years. The site of first recurrence was determined in all 49 (25%) patients who failed treatment: three (2%) developed local recurrence, six (3%) developed intransit recurrence, 24 (13%) developed positive regional lymph nodes, 15 (8%) developed systemic metastases, and one developed local recurrence plus positive regional nodes. Of these 49 patients failing treatment, 15 (31%) are currently surviving with no evidence of disease after retreatment of the recurrence. These data are compared to historical controls in the literature. It is concluded that regional control rates are improved by perfusion and that survival has probably been improved. In 14 patients treated by perfusion without local excision, regional control and survival was poor. Single drug (L‐PAM) perfusion with the techniques employed is effective in controlling regional subclinical disease, but the primary should be widely excised.