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Minimally invasive isolated limb perfusion - technical details and initial outcome of a new treatment method for limb malignancies

Journal article
Authors Roger Olofsson Bagge
Per Carlson
Roya Razzazian
Christoffer Hansson
Anders Hjärpe
J. Mattsson
Dimitrios Katsarelias
Published in International Journal of Hyperthermia
Volume 35
Issue 1
Pages 667-673
ISSN 0265-6736
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Institute of Clinical Sciences, Department of Radiology
Institute of Clinical Sciences
Pages 667-673
Language en
Keywords Isolated limb perfusion, minimally invasive, ILP, MI-ILP, ILI, complete remission, cell lymphoma, actinomycin-d, melphalan, infusion, melanoma, extremity, survival, chemotherapy, multicenter, Oncology, Radiology
Subject categories Cancer and Oncology


Objective: Isolated limb perfusion (ILP) and isolated limb infusion (ILI) are treatment options for patients with locally advanced melanomas and sarcomas of the extremities. ILP potentially have higher response rates, but requires open surgery for vascular access, whereas ILI is minimally invasive and easier to perform. We now present the technical details and outcome of a new approach to ILP by a minimally invasive vascular access (MI-ILP). Methods: Six patients, five with melanoma in-transit metastases and one with squamous cell carcinoma, were included in a phase I feasibility trial. Percutaneous vascular access of the extremity vessels was performed and the inserted catheters were then connected to a perfusion system. Results: All six treated patients underwent the procedure without the need for conversion to open surgery. The median operating time was 164 min and the median leakage rate was 0.1%. The complete response rate was 67%. Four patients (67%) had a Wieberdink grade II reaction and two patients (33%) had a grade III reaction. Conclusions: MI-ILP is feasible and gives the same treatment characteristics as open ILP, but with the advantage of a minimally invasive vascular access.

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