Perfusion can be used to treat a variety of cancers in the arms and legs. Melanomas, sarcomas and some localized cutaneous lymphomas have been treated with this method, but it has been most widely and effectively used to treat cutaneous malignant melanoma. ( See "Melanoma" .)
This cancer can be cured surgically if the tumor is discovered at an early stage, but isolated heated limb perfusion is suggested for people with extensive local tumors. And perfusing may be the treatment of choice for those who have melanomas involving the palms of the hands, the soles of the feet and the fingernails and toenails (subungual areas). Melanomas in these locations tend to have a poor prognosis .
People who have locally recurrent melanomas or spreading melanomas that are traveling away from the primary site toward nearby lymph nodes—the prognosis is very grave in both situations—are best treated by perfusion.
Results of Treatment Whether the treatment leads to a beneficial outcome depends on the stage of the cancer. There is some controversy about whether people with high-risk Stage I melanoma should have prophylactic perfusion or just surgery alone. One report has shown increased disease-free survival for Stage I patients treated with perfusion.
The five-year cure rate for acrolentiginous melanomas treated with perfusion ranges from 70 to 78 percent; the cure rate for the same lesions treated without perfusion ranges from 38 to 50 percent. On the average, perfusion offers people with Stage II or III melanomas a 20 to 25 percent increased survival over other treatment methods.
