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Isolated Limb Perfusion for Melanoma in Transit Metastases

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Regional Cancer Therapy

Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

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Abstract

The treatment of melanoma in transit metastases can vary widely and is dependent on the size and number of lesions. When many, large lesions exist, isolated limb perfusion (ILP) can be used as an attractive treatment option with high response rates. We review here the various methods of treatment for melanoma in transit metastases, with a focus on ILP. Indications and results are discussed, and the extra value of tumour necrosis factor (TNF) is evaluated. ILP with melphalan results in complete response rates of 40 to 82% (54% in a large retrospective metaanalysis). The addition of TNF can improve these complete response rates (59–85%), and although no data from randomized controlled trials are available, TNF seems of particular value in large, bulky lesions or in patients with recurrent disease after previous ILP. TNF-based ILP has earned a permanent place in the treatment of patients with melanoma it transit metastases. In patients with a high tumor burden, TNF-based ILP is the most efficacious procedure to obtain local control and achieve limb salvage.

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Authors and Affiliations

  1. Department of Surgical Oncology, Erasmus University Medical Center-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

    Flavia Brunstein MD, Dirk J. Grünhagen MD, Timo ten Hagen PhD & Alexander M. M. Eggermont MD, PhD

Authors
  1. Flavia Brunstein MD
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  2. Dirk J. Grünhagen MD
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  3. Timo ten Hagen PhD
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  4. Alexander M. M. Eggermont MD, PhD
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Editors and Affiliations

  1. Robert-Rössle-Hospital and Tumor Institute, Charité University of Medicine, Berlin

    Peter M. Schlag MD (Professor and Head of Surgical Oncology) (Professor and Head of Surgical Oncology)

  2. Max-Delbrück-Center for Molecular Medicine, Berlin, Germany

    Peter M. Schlag MD (Professor and Head of Surgical Oncology) & Ulrike Stein PhD (Assistant Professor) (Professor and Head of Surgical Oncology) &  (Assistant Professor)

  3. Tumor Metastasis and Therapy Response Program, Robert-Rössle-Hospital and Tumor Institute, Charité University of Medicine, Berlin

    Ulrike Stein PhD (Assistant Professor) (Assistant Professor)

  4. Erasmus University MC—Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

    Alexander M. M. Eggermont MD, PhD (Professor and Head of Surgical Oncology) (Professor and Head of Surgical Oncology)

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© 2007 Humana Press Inc., Totowa, NJ

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Brunstein, F., Grünhagen, D.J., ten Hagen, T., Eggermont, A.M.M. (2007). Isolated Limb Perfusion for Melanoma in Transit Metastases. In: Schlag, P.M., Stein, U., Eggermont, A.M.M. (eds) Regional Cancer Therapy. Cancer Drug Discovery and Development. Humana Press. https://doi.org/10.1007/978-1-59745-225-0_26

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  • DOI: https://doi.org/10.1007/978-1-59745-225-0_26

  • Publisher Name: Humana Press

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  • Online ISBN: 978-1-59745-225-0

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