TY - JOUR
T1 - Hyperthermic isolated limb perfusion with tumor necrosis factor α, interferon gamma, and melphalan for locally advanced nonmelanoma skin tumors of the extremities
T2 - A multicenter study
AU - Olieman, Annette F.T.
AU - Liénard, Danielle
AU - Eggermont, Alexander M.M.
AU - Kroon, Bin B.R.
AU - Lejeune, Ferdy J.
AU - Hoekstra, Harald J.
AU - Koops, Heimen Schraffordt
PY - 1999/3
Y1 - 1999/3
N2 - Background: Hyperthermic isolated limb perfusion (HILP) with tumor necrosis factor α (TNF-α), 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-α, 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-α, interferon gamma, and melphalan should be considered as a limb-saying treatment modality in patients with locally advanced nonmelanoma skin tumors of the extremities who would otherwise be candidates for ablative surgery.
AB - Background: Hyperthermic isolated limb perfusion (HILP) with tumor necrosis factor α (TNF-α), 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-α, 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-α, interferon gamma, and melphalan should be considered as a limb-saying treatment modality in patients with locally advanced nonmelanoma skin tumors of the extremities who would otherwise be candidates for ablative surgery.
UR - http://www.scopus.com/inward/record.url?scp=0345471470&partnerID=8YFLogxK
U2 - 10.1001/archsurg.134.3.303
DO - 10.1001/archsurg.134.3.303
M3 - Article
C2 - 10088573
AN - SCOPUS:0345471470
SN - 0004-0010
VL - 134
SP - 303
EP - 307
JO - Archives of Surgery
JF - Archives of Surgery
IS - 3
ER -