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

Annette F.T. Olieman, Danielle Liénard, Alexander M.M. Eggermont, Bin B.R. Kroon, Ferdy J. Lejeune, Harald J. Hoekstra, Heimen Schraffordt Koops

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Samenvatting

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.

Originele taal-2Engels
Pagina's (van-tot)303-307
Aantal pagina's5
TijdschriftArchives of Surgery
Volume134
Nummer van het tijdschrift3
DOI's
StatusGepubliceerd - mrt. 1999
Extern gepubliceerdJa

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