Long-term outcome of hyperthermic isolated limb perfusion (HILP) in the treatment of locoregionally metastasised malignant melanoma of the extremities

Figures & data

Table I.  Local tumour control after HILP according to M.D. Anderson stage.

	IIIA (%) (n = 51)	IIIAB (%) (n = 43)	IV (%) (n = 58)
Complete response	76 (n = 39)	63 (n = 27)	43 (n = 25)
Partial response	12 (n = 6)	21 (n = 9)	19 (n = 11)
No response	6 (n = 3)	12 (n = 5)	34 (n = 20)
Not evaluable	6 (n = 3)	5 (n = 2)	3 (n = 2)

Figure 1. Cumulative survival dependent on local tumour response after HILP (p = 0.001).

Figure 2. Overall survival dependent on M.D. Anderson stage (p < 0.001).

Table II.  Wieberdink classification 6.

Grade	Local tissue reaction
I	No subjective or objective oedema
II	Slight erythema and/or oedema
III	Considerable erythema and/or oedema damage with some blistering to the deep tissues; slightly disturbed motility permissible
IV	Extensive epidermolysis and/or obvious damage to the deep tissues, causing definitive functional disturbances; threatening or manifest compartmental syndromes
V	Reaction which may necessitate amputation

Table III.  Postoperative complications.

Complication	n	%
Lymph fistula	49	32
Lymphocele	6	4
Blistering (grade III toxicity)	12	8
Superficial wound infection	18	12
Deep wound infection	8	5
Compartment syndrome (grade IV toxicity)	6	4
Anaemia	12	8
Leucopenia^1	8	5
Thrombopenia^2	1	1
Peripheral nerve palsy	1	1
Bleeding necessitating surgery	1	1
Amputation (grade V toxicity)	2	1
Death (multiple organ failure)	1	1

¹2000–4000/µL at the lowest.

²<100 000/µL.

Wieberdink J, Benckhuijsen C, Braat RP, van Slooten EA, Olthuis GA. Dosimetry in isolation perfusion of the limbs by assessment of perfused tissue volume and grading of toxic tissue reactions. Eur J Cancer Clin Oncol 1982; 18: 905–910

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