Hyperthermic regional perfusion with melphalan and a combination of melphalan and actinomycin D in the treatment of locally metastasized malignant melanomas of the extremities.

From September 1969 through 1979, 68 patients with already locally metastasized malignant melanomas of the extremities were treated by hyperthermic regional perfusion and local excision(s). Of these, 53 patients could be evaluated after a follow-up of at least 2 years: 31 had been perfused with melphalan and 22 with melphalan in combination with actinomycin D. Local recurrence rates were about the same in both groups: 32 versus 33%. The same applied to the symptom-free interval between perfusion and local recurrence: about 12 versus about 13 months. Virtually all recurrences in both groups (90 versus 85%) were seen within 2 years. The interval between perfusion and systemic metastization was also roughly the same: about 25 versus about 23 months. These results indicate the need for better chemotherapeutics in order to achieve further improvement. The results of these perfusions were otherwise by no means disappointing, and hyperthermic regional perfusion is indicated in the treatment of patients with locally metastasized malignant melanomas.