Isolation limb perfusion for melanoma: current trends and future directions.

The current review summarizes briefly the reported limitations of the literature on isolation limb perfusion for melanoma, as well as current clinical research in the use of this modality. The most intriguing advance has been the combination of the cytokine tumour necrosis factor with melphalan; this has yielded a consistent complete response rate of 90%. Not all responses remain durable, and the impact of this very effective combination but potentially toxic regimen on patient survival remains to be shown. Future challenges in the field are proposed.