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Adjuvant regional isolated perfusion with melphalan for patients with clark V melanoma of the extremities
Author(s) -
Vrouenraets Bart C.,
Kroon Bin B. R.,
Klaase Joost M.,
Van Gell Bert N.,
Eggermont Alexander M. M.,
Franklin Hilary R.
Publication year - 1993
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930520411
Subject(s) - medicine , melphalan , melanoma , stage (stratigraphy) , perfusion , adjuvant , adjuvant therapy , surgery , lymph node , oncology , chemotherapy , cancer research , paleontology , biology
From 1978 to 1990, 32 patients with Clark V melanoma were treated by wide excision of the primary and adjuvant regional isolated perfusion with melphalan. M.D. Anderson stage of disease was stage I in 22 and stage IIIb in 10 patients. Five‐year survival rates were 58% and 27%, respectively. Seven patients developed a recurrence in the perfused limb [stage I, 2, stage IIIb, 5 patients ( P = 0.03)], and 4 of 17 patients developed regional lymph node metastases. Of the well‐known prognostic variables, only ulceration of the primary tumor significantly influenced survival ( P = 0.03). We did not see any improvement in survival rates compared with literature data on nonperfused patients. In the absence of data on locoregional recurrence rates in nonperfused Clark V melanoma patients, we cannot say whether adjuvant perfusion diminished this risk. Therefore, the results of the prospective randomized EORTC/WHO trial in primary high‐risk extremity melanoma have to be awaited. © 1993 Wiley‐Liss, Inc.