Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
Int J Hyperthermia. 2013 Sep;29(6):551-7. doi: 10.3109/02656736.2013.802374. Epub 2013 Jul 18.
The aim of the present study is to describe our experience with isolated limb perfusion (ILP) in the treatment of in-transit metastases of malignant melanoma and to determine prognostic factors for response, local progression, survival and toxicity.
A retrospective follow-up of all patients (n = 163) treated between January 1984 and December 2008 using data collected from individual patient records and the Swedish National Patient Register.
Clinical response was evaluable in 155 patients, 65% had a complete response (CR) and 20% had a partial response (PR). Local progression occurred in 63% of the patients after a median time of 16 months. Negative prognostic factors in univariate analyses were proximal location of the primary tumour, >10 in-transit metastases and if there was no CR after ILP. In multivariate analysis, proximal location of the primary tumour and no CR after ILP were significant prognostic factors. Median cancer-specific survival was 30 months, and negative prognostic factors in univariate analyses were male gender, positive lymph node status, systemic metastases, bulky tumour, >10 in-transit metastases and if there was no CR after ILP. In multivariate analysis, positive lymph node status, bulky tumour and no CR after ILP were significant prognostic factors. A majority (97%) of the patients had a Wieberdink grade II-III local toxicity. Four patients underwent limb amputation after a median of 19 months, none because of toxicity.
We found that ILP is a safe method with a high response rate for the treatment of patients with in-transit metastases of malignant melanoma.
本研究旨在描述我们在孤立肢体灌注（ILP）治疗恶性黑色素瘤转移中的经验，并确定反应、局部进展、生存和毒性的预后因素。
回顾性随访 1984 年 1 月至 2008 年 12 月期间使用从个体患者记录和瑞典国家患者登记处收集的数据治疗的所有患者（n=163）。
155 例患者可评估临床反应，65%完全缓解（CR），20%部分缓解（PR）。中位时间为 16 个月后，63%的患者出现局部进展。单因素分析中的负预后因素包括原发肿瘤的近端位置、>10 个转移灶和 ILP 后无 CR。多因素分析中，原发肿瘤的近端位置和 ILP 后无 CR 是显著的预后因素。中位癌症特异性生存时间为 30 个月，单因素分析中的负预后因素包括男性、阳性淋巴结状态、全身转移、巨大肿瘤、>10 个转移灶和 ILP 后无 CR。多因素分析中，阳性淋巴结状态、巨大肿瘤和 ILP 后无 CR 是显著的预后因素。大多数（97%）患者出现 Wieberdink 分级 II-III 级局部毒性。4 例患者在中位 19 个月后接受了截肢，均不是因为毒性。
我们发现，ILP 是一种安全的方法，对治疗恶性黑色素瘤转移中的患者具有高反应率。
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