Deliberate hypoxic pelvic and limb chemoperfusion in the treatment of recurrent melanoma

Stefano Guadagni, Filippo Russo, Carlo Riccardo Rossi, Pier Luigi Pilati, Diego Miotto, Giammaria Fiorentini, Marcello Deraco, Mario Santinami, Giancarlo Palumbo, Marco Valenti, Gianfranco Amicucci

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Abstract

Background: The treatment of patients with advanced or recurrent pelvic melanoma, which are often associated with lesions in the lower limbs, is still unsatisfactory and controversial. A simplified hypoxic pelvic and limb perfusion has been recently recommended to provide therapeutic options for palliation and possibly cure. Methods: A nonrandomized and noncontrolled phase II experimental study was performed in 11 patients with symptomatic unresectable recurrent melanoma of the pelvis and limb. Patients were submitted to hypoxic pelvic and limb perfusion with 25 mg/m2 of melphalan, 50 mg/m2 of cisplatin, 300 mg/m2 of dacarbazine, and 75 mg/m2 of epirubicin by means of a simplified balloon occlusion technique. Response rate and time to disease progresion were the primary endpoints; overall survival was the secondary endpoint. Results: During the procedures there were no technical, hemodynamic, or vascular complications, and no deaths occurred during surgery or in the postoperative period. Response rate was 82% (95% confidence interval, 58% to 100%). Median time to disease progression was 12 months (range 9 to 30 months). Three-year overall survival was 34%. Conclusions: Hypoxic pelvic and limb perfusion is a safe and good palliative treatment for patients with unresectable recurrent melanoma. Further studies are necessary to to confirm these data and to establish if refinements can be made with acceptable toxicity.

Original languageEnglish
Pages (from-to)28-36
Number of pages9
JournalAmerican Journal of Surgery
Volume183
Issue number1
DOIs
Publication statusPublished - 2002

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Keywords

  • Hypoxia
  • Locoregional chemotherapy
  • Melanoma
  • Melphalan
  • Perfusion
  • Stop flow

ASJC Scopus subject areas

  • Surgery

Cite this

Guadagni, S., Russo, F., Rossi, C. R., Pilati, P. L., Miotto, D., Fiorentini, G., Deraco, M., Santinami, M., Palumbo, G., Valenti, M., & Amicucci, G. (2002). Deliberate hypoxic pelvic and limb chemoperfusion in the treatment of recurrent melanoma. American Journal of Surgery, 183(1), 28-36. https://doi.org/10.1016/S0002-9610(01)00841-8