gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Stage-related response and recurrence rates in malignant melanoma with locoregional metastases treated by hyperthermic isolated limb perfusion (HILP)

Meeting Abstract

  • corresponding author presenting/speaker Christian Knorr - Unversitätsklinik Chirurgie Erlangen, Deutschland
  • Nathaniel Melling - Unversitätsklinik Chirurgie Erlangen
  • Jonas Göhl - Unversitätsklinik Chirurgie Erlangen
  • Werner Hohenberger - Unversitätsklinik Chirurgie Erlangen
  • Thomas Meyer - Unversitätsklinik Chirurgie Erlangen

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO609

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Veröffentlicht: 20. März 2006

© 2006 Knorr et al.
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Introduction: Hyperthermic isolated limb perfusion (HILP) is an efficient mode of treatment for locoregional metastases, especially for intransit-metastases. Our treatment protocol has constantly been developed and modified, due to our experience and experiments we performed. This analysis of the patients treated with the latest protocol during the last eleven years will document the outcome of these patients.

Patients: 101 patients were treated with HILP using Melphalan and Actinomycin D between September 1992 and November 2003. 40 patients were diagnosed in M. D. Anderson’s stage IIIa (intransit-metastases), one patient in stage IIIb (lymph node metastases), 51 patients in stage IIIab (intransit-metastases and lymph node metastases) and nine patients had stage IV disease. The 35 male and 66 female patients had a median age of 62 years of age (average: 61, range: 28-83). The median post-operative follow-up period was 21 months (range: 1-134).

Results: Local response: Complete response was achieved in 58 patients (57.4%), minor response in 21 cases (20.8%). Only 8 patients (7.9%) showed no response to the treatment. As expected the response rate was lower the more advanced the tumor stage was. Survival: Total survival after HILP averaged at 56 months (median 42 months), the five year survival rate averaged at 38%. The survival corresponded to the stage of tumor. Longest survival was achieved by the patients with stage IIIa disease with a five year survival rate of 47% opposed to 35% in stage IIIab and 34% in stage IV disease. The local response proved to be a further prognostic factor for survival. Recurrence: Locoregional recurrence was observed after a median of 21 months in patients with complete response. There was no complete response that persisted for longer than five years. Ten patients died in the stage of complete response with a median survival of 15.5 months. Locoregional recurrence also proved to depend on the stage of disease. Metastases: Local response markedly prolonged the interval till the occurrence of metastases: patients with minor response developed metastases after a median of 8 months (average: 20 months), whereas metastases occurred after a median of 30 months (average: 49 months) in patients with complete response.

Conclusion: No other method of treatment (such as chemotherapy or locoregional surgery) achieves response rates similar to HILP. Long-term survival is possible in cases with limited locoregional disease. HILP is associated with an intensive technological procedure and may therefore only be performed in few equipped centres.