Long-term functional morbidity after mild hyperthermic isolated limb perfusion with melphalan

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• 作者：B C. ; Vrouenraets ; G. J. in » ; t Veld ; O. E. Nieweg ; G. W. van Slooten ; J. A. van Dongen ; B. B. R. Kroon
• 关键词：melanoma ; isolated limb perfusion ; melphalan ; functional morbidity.
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：1999
• 出版时间：October 1999
• 年：1999
• 卷：25
• 期：5
• 页码：503-508
• 全文大小：71 K

文摘

Aims: To assess long-term functional morbidity in patients entered in the prospective randomized EORTC trial investigating the role of adjuvant isolated limb perfusion (ILP) with melphalan for high-risk primary melanoma. Methods: In 65 patients (ILP 36, wide excision only 29), limb circumference and joint mobility measurements were performed on the treated and the contralateral limb after a mean interval of 48 months after primary treatment. The two treatment groups were comparable regarding age, sex distribution, percentage of skin grafts or regional lymph-node dissections, and interval between primary treatment and physical measurements. Results: None of the patients had severe complaints of the treated limb at the time of analysis. The ankle suffered most from ILP, with a statistical significant restricted extension in approximately 40 % of the perfused patients. Abduction of the shoulder was minimally affected in treated upper limbs, probably as a result from the formation of scar tissue after axillary lymph-node dissection. Although no significant differences could be demonstrated in the circumference of upper or lower limbs, atrophy was seen in 24 % of perfused lower limbs. Of the five perfused patients who developed oedema, four had also undergone a regional lymph-node dissection. Conclusion: This risk of long-term functional morbidity should be weighed against the possible advantages of ILP in patients with limb melanoma or sarcoma.