Annals of Surgical Oncology

, Volume 4, Issue 6, pp 506–510 | Cite as

Tourniquet infusion chemotherapy for extremity in-transit lesions in malignant melanoma

  • Constantine P. Karakousis
  • Konstantinos Kontzoglou
  • Deborah L. Driscoll
Original Articles


Background: Perfusion remains the standard of regional chemotherapy for extremity in-transit lesions from melanoma. However, there is an interest in other forms of intraarterial chemotherapy due to the simplicity and feasibility of repeat administration of the latter.

Methods: Review of 51 patients with extremity in-transit lesions from melanoma treated with the tourniquet infusion (TI) method on the basis of a prospective protocol. Drugs used were either Adriamycin (group A) or Dacarbazine (DTIC) + cisDDP (group B). The median number of courses was two. Lesions were resected at the same time as TI (n=27) or after a month or more of observation in the absence of complete regression.

Results: There was no significant difference in response rates between groups A and B. The overall objective response rate in 24 evaluable patients was 75%, being complete in seven (29%), partial (>50%) in 11 (46%), minor (<50%) in three (12.5%), and progression of disease in three (12.5%). At a mean follow-up time of 40 months, no recurrence was observed in the treated extremity in 18 patients (35%), but further recurrences were noted in 31 patients (61%). The 5-year survival rate was 30%.

Conclusion: TI provides an objective response rate of 75% for in-transit Iesions, but after TI and resection of in-transit lesions as needed, the recurrence rate in the treated extremity is high (61%). Further work is needed with higher drug doses, local hyperthermia, or the administration of suitable doses of new regimens that are more successful with perfusion.

Key Words

Melanoma In-transit lesions Regional chemotherapy 


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Copyright information

© The Society of Surgical Oncology, Inc 1997

Authors and Affiliations

  • Constantine P. Karakousis
    • 1
  • Konstantinos Kontzoglou
    • 2
  • Deborah L. Driscoll
    • 3
  1. 1.Millard Fillmore HospitalFrom the State University of New YorkUSA
  2. 2.Roswell Park Cancer InstituteBuffaloUSA
  3. 3.Surgical OncologyMillard Fillmore HospitalBuffaloUSA

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