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Cutaneous Melanoma pp 1–31Cite as

Hyperthermic Regional Perfusion for Melanoma of the Limbs

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Abstract

Regional chemotherapy delivered using isolated limb perfusion for advanced extremity melanoma was developed in the late 1950s as a way to manage in-transit disease in an era when there were few systemic options for patients with metastatic melanoma. Over the years, the technique evolved to include hyperthermia and biologic compounds like tumor necrosis factor and became the main treatment for patients with in-transit melanoma. Since 2000, there has been a steady decline in the frequency of limb perfusion procedures. Initially this was related to the development of a less invasive technique to deliver regional chemotherapy called isolated limb infusion. More recently since 2010, the development of effective systemic treatments for melanoma, as well as novel intralesional therapies, has markedly altered the need for regional perfusion therapy such that it is uncommonly used. This chapter highlights the development and evolution of isolated limb perfusion therapy and what has changed in the last few years to replace it in managing patients with in-transit disease.

This chapter should be cross-referenced with the chapters on isolated limb infusion, in-transit disease, and intralesional injections for the management of in-transit disease.

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Authors and Affiliations

  1. Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA

    Douglas S. Tyler

  2. Department of Surgery, Division of Endocrine & Oncologic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Douglas L. Fraker

  3. Surgical Oncology Department of Surgery, University of Groningen, Groningen, The Netherlands

    Harald J. Hoekstra

  4. Departments of Surgery, Biochemistry and Molecular Biology and Pathology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    H. Richard Alexander Jr.

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  1. Douglas S. Tyler
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  2. Douglas L. Fraker
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  3. Harald J. Hoekstra
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  4. H. Richard Alexander Jr.
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Corresponding author

Correspondence to Douglas S. Tyler .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, University of Texas Southwestern, Dallas, TX, USA

    Charles Balch

  2. Division of Surgery, UT MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey Gershenwald

  3. Melanoma Institute of Australia, Wollstonecraft, Australia

    John Thompson

  4. Georgetown Medical Center, Washington, DC, USA

    Michael Atkins

  5. Melanoma and Skin Cancer Program, University of Pittsburgh, Pittsburgh, PA, USA

    John Kirkwood

  6. University of Sydney, Sydney, NSW, Australia

    Richard Kefford

  7. Department of Dermatology, Harvard Medical Center, Boston, MA, USA

    Arthur Sober

  8. Department of Dermatology, Memorial Sloan Kettering, New York, NY, USA

    Allan Halpern

  9. Department of Dermatology, University Hospital, Tübingen, Tübingen, Germany

    Claus Garbe

  10. Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown NSW, Australia

    Richard Scolyer

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Tyler, D.S., Fraker, D.L., Hoekstra, H.J., Richard Alexander, H. (2019). Hyperthermic Regional Perfusion for Melanoma of the Limbs. In: Balch, C., et al. Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-46029-1_26-1

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  • DOI: https://doi.org/10.1007/978-3-319-46029-1_26-1

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