Treatment of cutaneous metastases from malignant melanoma using the carbon-dioxide laser

Between October 1988 and September 1991, 60 patients with cutaneous metastases from malignant melanoma have been treated palliatively using carbon-dioxide laser ablation. The number of lesions per patient varied between 3 and 450; accordingly treatment was performed under local or general anaesthesia. The post-operative complication rate was low and the majority of wounds healed within 6 weeks. Control of in-transit metastatic disease and palliation of disseminated cutaneous melanoma can be achieved by carbon-dioxide laser ablation which provides a simple and effective alternative to isolated limb perfusion. Eighteen of the 32 patients in this series with stage IIIa disease were controlled by three or fewer laser treatments in the first year. We advocate laser vaporization as the initial treatment for non-nodal regional recurrence in the knowledge that isolated limb perfusion can be offered at a later stage for patients who cannot be controlled by the laser.