[Regional hyperthermic perfusion--therapeutic concept and long term results]

Isolation perfusion was introduced in 1957 by Creech and Krementz for treatment of malignancies of the limbs. The isolation of the extremity from the body circulation allows a high concentration of cytostatics without systemic side effects. Regionally metastasizing malignant melanomas with satellites, intransit or lymph node metastases are generally accepted indications for isolation perfusion. There is still controversy about elective adjuvant perfusion in stage I melanoma. Prospective randomized studies must clarify this situation. Krementz demonstrated long-term survival rates between 29% and 52%. Our group of patients with satellites and intransit metastases shows a 10-year survival rate of 48%. Considering the historical data of our patients without perfusion and with a 10-year survival of 11%, there is a highly significant statistical difference. In conclusion, isolation perfusion is the therapy of choice in patients with locally metastasized malignant melanoma of the limbs.