Normothermic isolation perfusion with melphalan for advanced melanoma of the limbs

Eighteen patients with advanced melanoma of the limbs underwent a single isolation perfusion with melphalan under normothermic conditions, i.e. tissue temperatures between 37.0 and 38.0 degrees C. There were no major complications. In 7 patients complete remission was achieved and in 8 the remission was partial, i.e. tumor reduction greater than 50%. No obvious response was seen in the remaining 3 patients. At the time of analysis 4 patients were still in complete remission, 56, 55, 19 and 8 months after perfusion, respectively. One patient died from distant spread, 17 months after perfusion, but without exhibiting new tumor growth in the perfused area. In 2 patients local control was transient with locally recurrent disease 28 and 10 months after perfusion, respectively. In patients with partial remission the duration of remission could not be determined because of supplementary treatment or death. Our results seem to be comparable to those obtained by so-called mild hyperthermic perfusions.