LIMB RECURRENCE-FREE INTERVAL AND SURVIVAL IN PATIENTS WITH RECURRENTMELANOMA OF THE EXTREMITIES TREATED WITH NORMOTHERMIC ISOLATED PERFUSION

To date, little is known about prognostic factors for limb recurrence- free interval and survival in patients with recurrent melanoma of the limbs treated with regional isolated perfusion. Therefore, 216 such pa tients treated with normothermic perfusion using melphalan during the period 1978 to 1990 were analyzed for patient and tumor related variab les using a Cox proportional hazard model. The five year limb recurren ce-free interval was 52 percent. For stage II (n=67), IIIA (n=71) and IIIAB and IIIB (n=78) disease separately, these percentages were 53, 5 6 and 47 percent. In stage II disease, patients with a local recurrenc e adjacent to scar or skin graft had a significantly better five year limb recurrence-free interval than patients with satellites (75 versus 33 percent; p=0.0009). prognostic factors for limb recurrence-free in terval were-in order of importance-tumor tissue left in situ, number o f previous limb recurrences and total tumor surface area. The overall five year survival rate was 42 percent. For stages II, IIIA and IIIAB and IIIB disease, these percentages were 57, 45 and 25 percent, respec tively. There was no survival benefit for patients with a local recurr ence. Prognostic factors for survival were, in order of importance, st age of disease, gender, age, Breslow thickness, Clark level of infiltr ation of the primary melanoma and the number of lesions forming the in dication for perfusion. The results of this study will eventually furt her delineate indications for perfusion.