Regional perfusion in the treatment of patients with a locally metastasized malignant melanoma of the limbs

During the period 1964–1977, regional perfusion and wide local excision were used in the treatment of 104 patients with a locally metastasized malignant melanoma of the limbs. One hundred patients were considered in a study of 3-year and 5-year survival, which was 52% ($\text{52}\text{100}$) and 38% ($\text{30}\text{78}$), respectively. The 3-year and 5-year survival rates in 18 patients treated by normothermic perfusion prior to 1969 were 22% ($\text{4}\text{18}$) and 17% ($\text{3}\text{18}$), respectively; in 82 patients treated by hyperthermic perfusion after 1969, the 3-year survival was 58.5% ($\text{48}\text{82}$) and the 5-year survival was 45% ($\text{27}\text{60}$). The difference between the normothermic and hyperthemic group is significant at the 3-year and 5-year level (P < 0.005 and P < 0.025, respectively). The 5-year survival in those treated by hyperthermic perfusion was 42% in stage II (n = 12) and 46% in stage III (n = 48), the difference not being significant. The male 5-year survival was 36% ($\text{8}\text{22}$), while the female was 53% ($\text{20}\text{38}$). The 5-year survival for tumours of the arm and those of the leg was 23% ($\text{3}\text{13}$) and 51% ($\text{24}\text{47}$), respectively. No significancy could be demonstrated between these groups. Of the entire group of 100 patients, 35 developed a local recurrence after perfusion; in 11 there was simultaneous general metastazation as well. The recurrence developed within 2 years after perfusion in 27 (77%) patients and 16 (76%) died within 2 years of recurrence.