Safety and efficacy of isolated limb perfusion in elderly melanoma patients

Ann Surg Oncol. 2002 Dec;9(10):968-74. doi: 10.1007/BF02574514.


Background: Older patients are assumed to have a higher risk of complications from isolated limb perfusion (ILP). A study was performed evaluating the safety and efficacy of ILP in patients older than 75 years with advanced melanoma of the limbs.

Methods: A total of 218 therapeutic ILPs with melphalan with or without tumor necrosis factor alpha were performed in 202 patients with advanced measurable melanoma and were analyzed retrospectively. Fifty-three patients (28%) were 75 years or older.

Results: Complete response rates were 56% for those older than 75 years and 58% for the younger group (P =.79). Locoregional relapse occurred in 56% of the older group versus 51% in the younger group (P =.61). Limb toxicity, systemic toxicity, local complications, and long-term morbidity were similar in both age groups. Perioperative mortality was low, with one procedure-related death in the older group. Older patients stayed in the hospital for a median of 23 days (younger patients, 19 days; P <.01).

Conclusions: ILP results in similar response rates in the elderly with recurrent melanoma, without increased toxicity, complications, or long-term morbidity compared with younger patients. Older age in itself is not a contraindication for ILP.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Alkylating / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Cancer, Regional Perfusion / adverse effects
  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Disease-Free Survival
  • Extremities*
  • Female
  • Humans
  • Length of Stay
  • Linear Models
  • Male
  • Melanoma / drug therapy*
  • Melanoma / mortality
  • Melanoma / pathology
  • Melphalan / administration & dosage
  • Melphalan / adverse effects
  • Multivariate Analysis
  • Netherlands / epidemiology
  • Retrospective Studies
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology
  • Survival Rate
  • Tumor Necrosis Factor-alpha / administration & dosage


  • Antineoplastic Agents, Alkylating
  • Tumor Necrosis Factor-alpha
  • Melphalan