TOTAL ABDOMINAL PERFUSION (TAP) IN THE TREATMENT OF ABDOMINAL METASTATIC MELANOMA

Total abdominal perfusion (TAP) is a recently described technique in w hich the abdominal organs are isolated from the systemic circulation a nd perfused by means of an external pump. Administering chemotherapy i nto the circuit provides higher locoregional drug exposure with lower systemic toxicity. Two patients with melanoma metastatic to the abdome n were treated using this technique. The first patient suffered from i ntractable upper gastrointestinal bleeding due to unresectable melanom a metastasis of the duodenum. He underwent TAP with melphalan and cisp latinum. His bleeding stopped and the tumor regressed. This patient's response lasted for 6 months. The second patient had an unresectable l iver metastasis. She underwent TAP with melphalan and DTIC, resulting in a complete response with disappearance of the liver mass, which las ted until her death in 13 months. Our conclusion is that TAP should be considered as a technique for regional chemotherapy, which may be use d in the treatment of unresectable metastatic melanoma of the abdomen. (C) 1994 Wiley-Liss, Inc.