In the period 1978-1990, 49 patients with locally inoperable melanoma
of the limbs were treated with regional isolated perfusion according t
o four different perfusion schedules. Perfusion resulted in a complete
remission in 28 patients (57%), with a median duration of 10 (1-55+)
months, and a partial remission in 10 (21%), with a median duration of
3 (1-9) months. In patients treated with a double (normothermic or se
quential hyperthermic) perfusion schedule the complete remission rate
was higher. Regional lymph node involvement reduced the chance of achi
eving complete remission. Twelve patients with complete remission (43%
) showed a relapse in the perfused area. The corresponding 3-year limb
recurrence-free interval was 46%. This interval was mainly influenced
by the number of lesions at the moment of perfusion. Three of the pat
ients who failed to respond eventually required amputation of the affe
cted limb. The median follow-up of the surviving patients was 23 (5-14
2) months. At the time of analysis 23 patients were still alive, 12 of
whom had no evidence of disease. Patients with complete remission had
a slightly, though statistically not significant better 3-year surviv
al rate than patients without complete remission (49% vs 33%). Regiona
l isolated perfusion halted progression in all of these 49 patients an
d resulted in a complete remission for 57%. It is, therefore, an impor
tant modality in the management of patients with locally inoperable me
lanoma and provides a valuable alternative to amputation.