Isolated limb perfusion (ILP) is an operation for a type of metastatic melanoma called in-transit metastases. In transit metastases is spread of melanoma along lymphatic vessels in the skin which forms nodules either in the skin or under the skin away from the primary melanoma site. Most of the time there are too many nodules to simply cut them out with surgery because they will almost always recur. When this happens in an extremity (arm or leg) ILP can be performed. ILP is a surgical procedure on the blood vessels to and from the extremity. An operation is done to put tubes into the artery going into the leg and the vein leaving the leg. A heart lung bypass machine then circulates very high doses of a chemotherapeutic drug called melphalan through the arm or leg for an hour. In this way very high doses of chemotherapy can be given to the extremity without causing other side effects. Several thousand of this specialized procedure have been done in the United States and Europe over the past 30 years. Over 60% of patients that receive this treatment have all of their melanoma tumor nodules disappear (a complete response). The other 40% have a significant partial response. This means that a lot of the nodules disappear or shrink but not all of them.
For more information, please feel free to schedule an office visit to discuss this treatment in person.
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