SINGLE-CENTER PROSPECTIVE-STUDY OF ISOLATED LIMB PERFUSION WITH MELPHALAN IN THE TREATMENT OF SUBUNGUAL MALIGNANT-MELANOMA

Subungual melanoma is rare and experience in treating this condition w ith isolated limb perfusion is limited. Between 1985 and 1990, 24 pati ents were treated by digital amputation and isolated limb perfusion wi th melphalan and mild hyperthermia. The disease was staged according t o the M.D. Anderson classification: stage I (17 patients), stage IIIA (one), stage IIIB (two) and stage IIIAB (four). Thirteen lesions were on the foot and 11 on the hand. Seven patients have developed locoregi onal recurrence. The estimated overall 2- and 5-year probabilities of survival were 77 and 46 per cent respectively, while for disease-free survival the rates were 59 and 51 per cent. When these results were co mpared retrospectively with those in 111 patients treated by amputatio n alone, no significant difference in survival was demonstrated. This experience suggests that isolated limb perfusion with melphalan and mi ld hyperthermia confers no additional survival benefit over appropriat e surgery.