Combined Hyperthermia and Chemotherapy for Malignant Melanoma of the Limbs

  • F. Truchetet
  • E. Grosshans
  • J. C. Kretz
  • J. Friedel
  • C. Chartier
Part of the Clinical Thermology book series (CLIN THERM)


Malignant melanoma represents about 5% of skin cancers and 2% of malignant tumors (excluding the other skin cancers). Its incidence is extremely variable and is evaluated at 0.3/100000 inhabitants in Japan and up to 40/100000 inhabitants in Queensland, Australia, a number which is considered the highest in the world.


Primary Malignant Melanoma Isolate Limb Perfusion Actuarial Survival Rate Superficial Spreading Melanoma Recurrent Melanoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ackerman LV, Del Regato JA (1962) Malignant melanoma of the skin. In: Cancer: diagnosis, treatment, and prognosis. Mosby -cV, St LouisGoogle Scholar
  2. 2.
    Aigner KR, Hüd P, Hundeiker M (1981) Neue Entwicklungen in der isolierten Extremitäten Perfusion. Z Hautkr 57:1044–1054Google Scholar
  3. 3.
    Aigner KR, Walther H, Link KH, Voigt H (1986) Perfusionstherapie. In: Voigt H, Kleeber UR (eds) Malignes Melanom. Springer, Berlin Heidelberg New York, pp 299–305CrossRefGoogle Scholar
  4. 4.
    Bulman AS, Jamieson CW (1980) Isolated limb perfusion with melphalan in the treatment of malignant melanoma. Br J Surg 67: 660–662PubMedCrossRefGoogle Scholar
  5. 5.
    Cavalière R, Ciocatto E, Giovanella B, Heidelberger C, Johnson R, Magottini M, Mondovi B, Moricca G, Rossi-Favelli A (1967) Selective heat sensitivity of cancer cells. Biochemical and clinical studies. Cancer 20:1351–1381PubMedCrossRefGoogle Scholar
  6. 6.
    Creech O, Krementz ET, Ryan RF, Winblad JN (1958) Chemotherapy of cancer: regional perfusion utilizing an extracorporeal circuit. Ann Surg 148:616–632PubMedCrossRefGoogle Scholar
  7. 7.
    Cruchley PM, Kaplan JA, Waller JL, Youg MR (1982) Anesthesia for isolated hyperthermic limb perfusion. Anesthesiology 57:228–230PubMedCrossRefGoogle Scholar
  8. 8.
    Cumberlin R, De Moss E, Lassus M, Freidman M (1985) Isolation perfusion for malignant melanoma of the extremity: a review. J Clin Oncol 3:1022–1031PubMedGoogle Scholar
  9. 9.
    Davis CD, Ivins JC, Soule EH (1976) Mayo Clinic experience with isolated limb perfusion for invasive malignant melanoma of the extremities. Proceedings of the ninth international pigment cell conference, Houston Texas. In: Riley R (ed) Pigment cell. Karger S, New York, pp 379–385Google Scholar
  10. 10.
    De Cosse JJ, Rogers LS (1966) Influence of high pressure oxygen and chemotherapy of the A. Mel 4 hamster melanoma. Cancer Res pt 1:287–292Google Scholar
  11. 11.
    Didolkar MS, Fitzpatrick JL, Jackson AJ, Johnson GS (1986) Toxicity and complications of vascular isolation and hyperthermic perfusion with imidazole carboxamide in melanoma. Cancer 57:1961–1966PubMedCrossRefGoogle Scholar
  12. 12.
    Fletcher JR, White CR, Fletcher WA (1986) Improved survival rates of patients with acral lentiginous melanoma treated with hyperthermic isolation perfusion, wide excision, and regional lymphadenectomy. Am J Surg 151:593–597PubMedCrossRefGoogle Scholar
  13. 13.
    Fontijne WPJ, Mook PH, Schraffordt-Koops J, Oldhoff J, Wildevuur RH (1985) Improved tissue perfusion during pressure regulated hyperthermic regional isolated perfusion. A clinical study. Cancer 55:1455–1461PubMedCrossRefGoogle Scholar
  14. 14.
    Ghussen F, Nagel K, Groth W (1981) Regionale hyper-therme Zytostatikaperfusion bei malignen Melanomen der Extremitäten. Dtsch Med Wochenschr 106:1612–1615PubMedCrossRefGoogle Scholar
  15. 15.
    Ghussen F, Nagel K, Groth W, Müller JM, Stützer H (1984) A prospective randomized study of regional extremity perfusion in patients with malignant melanoma. Ann Surg 200:764–768PubMedCrossRefGoogle Scholar
  16. 16.
    Ghussen F, Kruger I, Groth W, Stützer H (1986) Randomized melanoma study of perfusion of the extremities. Results of treatment 21/2 years after premature discontinuation. Chirurg 57:619–623PubMedGoogle Scholar
  17. 17.
    Ghussen F, Kruger I, Groth W, Stützer H (1988) The role of regional hyperthermic cytostatic perfusion in the treatment of extremity melanoma. Cancer 61:654–659PubMedCrossRefGoogle Scholar
  18. 18.
    Golomb FM, Bromberg J, Dubin N (1979) A controlled study of the survival experience of patients with primary malignant melanoma of the distal extremities treated with adjuvant isolated perfusion. Adjuvant Ther Cancer 2:519–526Google Scholar
  19. 19.
    Gundersen S, Hager B, Tausjo J (1986) Radiation in combination with intra-arterial infusion therapy with dacarbazine for metastatic malignant melanoma localized to a lower extremity. Cancer Treat Rev 70:1015–1017Google Scholar
  20. 20.
    Janoff KA, Moseson D, Nohlgren J, Davenport C, Richards C, Fletcher WS (1982) The treatment of stage I melanoma of the extremities with regional hyperthermic isolation perfusion. Ann Surg 196:316–323PubMedCrossRefGoogle Scholar
  21. 21.
    Klein ES, Ben-Ari GY (1987) Isolation perfusion with cis-platin for malignant melanoma of the limbs. Cancer 59:1068–1071PubMedCrossRefGoogle Scholar
  22. 22.
    Klopp C, Alford T, Bateman J, Berry G, Winship T (1950) Fractionated intra-arterial cancer chemotherapy with methyl bis amine hydrochloride. A preliminary report. Ann Surg 132:811–832PubMedCrossRefGoogle Scholar
  23. 23.
    Krementz ET (1986) Regional perfusion. Current sophistication, what next? Cancer 57:426–432CrossRefGoogle Scholar
  24. 24.
    Krementz ET, Knudson L (1961) The effect of increased oxygen tension on the tumoricidal effect of nitrogen mustard. Surgery 50:266–271PubMedGoogle Scholar
  25. 25.
    Krementz ET, Ryan RF (1972) Chemotherapy of melanoma of the extremities by perfusion; fourteen years clinical experience. Ann Surg 175:900–917PubMedCrossRefGoogle Scholar
  26. 26.
    Krementz ET, Carter RD, Sutherland CM, Campbell M (1979) The use of regional chemotherapy in the management of malignant melanoma. World J Surg 3:289–304PubMedCrossRefGoogle Scholar
  27. 27.
    Krementz ET, Carter RD, Sutherland CM, Muchmore JH (1987) Chemotherapy by regional perfusion for limb melanoma. Am Surg 53:133–140PubMedGoogle Scholar
  28. 28.
    Lee YTNM (1980) Loco-regional recurrent melanoma. I. Natural history. Cancer Treat Rev 7:59–72PubMedGoogle Scholar
  29. 29.
    Lejeune F, Achten G (1983) Le mélanome malin cutané. Stratégies et résultats thérapeutiques. In: Le mélanome malin. XVIIe congrès de l’association des dermatologistes et syphiligraphes de langue française. Brussels, June 2–4, pp 249–291Google Scholar
  30. 30.
    Luck J (1956) Action of p-[di(2-chloroethylamino-L-phenylalanine] on Harding Passey mouse melanoma. Science 123:984–985PubMedCrossRefGoogle Scholar
  31. 31.
    Martijn H, Olkhoff J, Schraffordt-Koops H, Oosterhuis J (1982) Hyperthermic regional perfusion with melphalan and a combination of melphalan and actinomycin D in the treatment of locally metastasized malignant melanoma of the extremities. J Surg Oncol 20:9–13PubMedCrossRefGoogle Scholar
  32. 32.
    Martijn H, Oldhoff J, Oosterhuis JW, Schraffordt-Koops H (1983) Indications for elective groin dissection in clinical stage I patients with malignant melanoma of the lower extremity treated by hyperthermic regional perfusion. Cancer 52:1526–1534PubMedCrossRefGoogle Scholar
  33. 33.
    Martijn H, Schraffordt-Koops H, Milton GW, Nap M, Oosterhuis JW, Shaw HM, Oldhoff J (1986) Comparison of two methods of treating primary malignant melanomas Clark IV et V, thickness 1.5 mm and greater localized on the extremities. Cancer 57:1923–1930PubMedCrossRefGoogle Scholar
  34. 34.
    McBride CM, Sugarbaker EV, Hickey RC (1975) Prophylactic isolation perfusion as the primary therapy for invasive malignant melanoma of the limbs. Ann Surg 182:316–324PubMedCrossRefGoogle Scholar
  35. 35.
    Millar RD, Ketcham AS (1974) The effect of heparin and warfarin on primary and metastatic tumors. J Med 5:23–31PubMedGoogle Scholar
  36. 36.
    Minor DR, Allen RE, Alberts D, Peng YM, Tardellin G, Hutchinson J (1985) A clinical and pharmacokinetic study of isolated limb perfusion with heat and melphalan for melanoma. Cancer 55:2638–2644PubMedCrossRefGoogle Scholar
  37. 37.
    Nachbur B (1986) Die Perfusionsbehandlung des Extremitä-tenmelanomas. Indikationen, Technik, Komplikationen und Ergebnisse der regionalen Perfusionsbehandlung des malignen Melanomas der Extremitäten. Huber, Bern, p 104Google Scholar
  38. 38.
    Rampen FHJ (1985) Towards a rational perfusion strategy for malignant melanoma. Eur J Surg Oncol 11:117–118PubMedGoogle Scholar
  39. 39.
    Schraffordt-Koops H, Oldhoff J, Oosterhuis JW, Beekhuis H (1985) The role of isolated limb perfusion for regional metastases of the extremities. In: Balch CM (ed) Surgical approaches to cutaneous melanoma. Karger, Basel, pp 146–164 (Pigment Cell, vol 7.)Google Scholar
  40. 40.
    Shingleton WW, Seigler HF, Stocks LH, Downs RW (1975) Management of recurrent melanoma of the extremity. Cancer 35:574–579PubMedCrossRefGoogle Scholar
  41. 41.
    Shiu MH, Knapper WH, Fortner JG, Yeh S, Horowitz G, Schnog J, Guerra J, Gould-Rossbach P, Ray C (1986) Regional isolated limb perfusion of melanoma in transit metastases using mechlorethamine (nitrogen mustard). J Clin Oncol 4:1819–1826PubMedGoogle Scholar
  42. 42.
    Stehlin JS (1969) Hyperthermic perfusion with chemotherapy for cancers of the extremity. Surg Gynecol Obstet 129:305–308PubMedGoogle Scholar
  43. 43.
    Stehlin JS, Giovanella BC, De Ipolyi PD, Muenz LR, Anderson RF (1975) Results of hyperthermic perfusion for melanoma of the extremities. Surg Gynecol Obstet 140:339–348PubMedGoogle Scholar
  44. 44.
    Storm FK, Morton DL (1985) Value of therapeutic hyperthermic limb perfusion in advanced recurrent melanoma of the lower extremity. Am J Surg 150:32–35PubMedCrossRefGoogle Scholar
  45. 45.
    Storm FK, Silberman AW, Ramming KR, Kaiser LR, Harrison WH, Elliott RS, Haskell CM, Sarna G, Morton DL (1984) Clinical thermochemotherapy. A controlled trial in advanced cancer patients. Cancer 53:863–868PubMedCrossRefGoogle Scholar
  46. 46.
    Sugarbaker ER, McBride CM (1976) Survival and regional disease control after isolation perfusion for invasive stage I melanoma of the extremities. Cancer 37:188–198PubMedCrossRefGoogle Scholar
  47. 47.
    Sutherland CM, Mather FJ, Krementz ET (1987) Factors influencing the survival of patients with regional melanoma of the extremity treated by perfusion. Surg Gynecol Obstet 164:111–118PubMedGoogle Scholar
  48. 48.
    Tonak J, Hermanek P, Banz H, Groitl H (1979) Cytotoxics and hyperthermic perfusion: a preliminary study. Cancer Treat Rev 6:135–141PubMedCrossRefGoogle Scholar
  49. 49.
    Tonak J, Hohenbergen W, Göhl J (1984) Die isolierte hyper-therme Extremitätenperfusion bei malignen Melanomen und Weichgewebssarkomen. Chirurg 55:499–504PubMedGoogle Scholar
  50. 50.
    Van OS J, Schraffordt-Koops H, Oldhoff J (1985) Dosimetry of cytostatics in hyperthermic regional isolated perfusion. Cancer 55:698–701PubMedCrossRefGoogle Scholar
  51. 51.
    Wagner DE (1976) A retrospective study of regional perfusion for melanoma. Arch Surg 111:410–413PubMedGoogle Scholar
  52. 52.
    Wieberding J, Benckhuysen C, Braat RP, Van Slooten EA, Olthuis GAA (1982) Dosimetry in isolation perfusion of the limbs by assessment of perfused tissue volume and grading of toxic tissue reactions. Eur J Cancer Clin Oncol 18:905–910CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • F. Truchetet
  • E. Grosshans
  • J. C. Kretz
  • J. Friedel
  • C. Chartier

There are no affiliations available

Personalised recommendations