Hyperthermic isolated limb perfusion with tumor necrosis factor alpha, interferon gamma, and melphalan for locally advanced nonmelanoma skin tumors of the extremities: a multicenter study.

Details

Serval ID
serval:BIB_13244
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Hyperthermic isolated limb perfusion with tumor necrosis factor alpha, interferon gamma, and melphalan for locally advanced nonmelanoma skin tumors of the extremities: a multicenter study.
Journal
Archives of Surgery
Author(s)
Olieman A.F., Liénard D., Eggermont A.M., Kroon B.B., Lejeune F.J., Hoekstra H.J., Koops H.S.
ISSN
0004-0010
Publication state
Published
Issued date
1999
Peer-reviewed
Oui
Volume
134
Number
3
Pages
303-307
Language
english
Abstract
BACKGROUND: Hyperthermic isolated limb perfusion (HILP) with tumor necrosis factor alpha (TNF-alpha), interferon gamma, and melphalan has proved to be useful in the treatment of recurrent malignant melanoma and of locally advanced soft tissue sarcomas of the extremities. OBJECTIVE: To determine whether this modality is also effective in the treatment of locally advanced nonmelanoma skin tumors of the extremities. PATIENTS AND METHODS: Fifteen patients with locally advanced primary, recurrent, or metastatic skin tumors of the extremities (12 with squamous cell carcinoma and 3 with Merkel cell carcinoma) underwent HILP with TNF-alpha, interferon gamma, and melphalan. Six tumors were localized in the upper extremity (40%), and 9 in the lower extremity (60%). Treatment-related complications, limb salvage rate, local recurrence, and regional and distant metastases were scored during a median follow-up of 20 months. RESULTS: After HILP, 9 patients (60%) showed a complete response (with histopathological confirmation). Four patients (27%) showed a partial response (with histopathological confirmation in 1 patient), and 2 patients (13%) showed no change (with histopathological confirmation in 1 patient and with clinical evidence in 1 patient). Two patients (13%) showed treatment-related complications. The limb salvage was achieved in 12 patients (80%), and the local recurrences developed in 4 patients (27%). During follow-up, regional lymph node metastases were observed in 2 patients (13%) and distant metastases in 2 patients (13%). CONCLUSION: Based on our results, HILP with TNF-alpha, interferon gamma, and melphalan should be considered as a limb-saving treatment modality in patients with locally advanced nonmelanoma skin tumors of the extremities who would otherwise be candidates for ablative surgery.
Keywords
Adult, Aged, Antineoplastic Agents/therapeutic use, Arm, Carcinoma, Merkel Cell/drug therapy, Carcinoma, Squamous Cell/drug therapy, Chemotherapy, Cancer, Regional Perfusion/methods, Female, Follow-Up Studies, Hot Temperature, Humans, Interferon-gamma/therapeutic use, Leg, Male, Melphalan/therapeutic use, Middle Aged, Skin Neoplasms/drug therapy, Tumor Necrosis Factor-alpha/administration &amp, dosage
Pubmed
Web of science
Open Access
Yes
Create date
19/11/2007 12:04
Last modification date
20/08/2019 12:41
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