Surgical versus percutaneous isolated pelvic perfusion (IPP) for advanced melanoma: comparison in terms of melphalan pharmacokinetic pelvic bio-availability

BMC Res Notes. 2017 Aug 15;10(1):411. doi: 10.1186/s13104-017-2738-y.


Background: Isolated pelvic perfusion (IPP) can be used to treat unresectable melanoma metastases of the pelvis. IPP can be performed either by surgical or percutaneous approaches, using different balloon catheters. The aim of this study was to examine whether the surgical and percutaneous approaches were comparable with respect to tumor drug exposure in the pelvis.

Methods: A pharmacokinetic study was performed in 5 melanoma patients treated with surgical IPP and five with percutaneous IPP. Both groups received melphalan at the dose of 30 mg/m2. Melphalan pharmacokinetic analyses were performed and the main parameter used to evaluate pelvic tumor drug-exposure was the ratio of areas under the melphalan plasma concentration curves in the pelvis and the systemic compartment, during the perfusion time (AUC0 to 20). Non-parametric Mann-Whitney tests were employed for statistical comparisons.

Results: The median and interquartile range (IQR) values of the ratios between melphalan AUC0 to 20 in pelvic and systemic compartments were 7.9 (IQR 7.2 to 9.9) and 5 (IQR 4 to 7.9) for surgical and percutaneous IPPs, respectively (p = 0.209).

Conclusions: Tumor exposure to drug using these two methods did not statistically differ and both methods, therefore, can be adopted interchangeably, utilizing a perfusion blood flow rate of approximately 120 ml/min. The small sample size is a limitation of this study but our preliminary results can be used to calculate the effect size of a larger trial. Trial Registration Clinical Identifier NCT01920516; date of trial registration: August 6, 2013.

Keywords: Isolated pelvic perfusion; Melanoma; Melphalan.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Antineoplastic Agents, Alkylating / blood
  • Antineoplastic Agents, Alkylating / pharmacokinetics*
  • Antineoplastic Agents, Alkylating / pharmacology
  • Area Under Curve
  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Female
  • Humans
  • Male
  • Melanoma / blood supply
  • Melanoma / drug therapy*
  • Melanoma / pathology
  • Melanoma / surgery
  • Melphalan / blood
  • Melphalan / pharmacokinetics*
  • Melphalan / pharmacology
  • Middle Aged
  • Pelvic Neoplasms / blood supply
  • Pelvic Neoplasms / drug therapy*
  • Pelvic Neoplasms / pathology
  • Pelvic Neoplasms / surgery
  • Pelvis / blood supply
  • Pelvis / pathology
  • Pelvis / surgery
  • Pilot Projects
  • Statistics, Nonparametric
  • Surgical Procedures, Operative / methods*


  • Antineoplastic Agents, Alkylating
  • Melphalan

Associated data