First Experimental and Clinical Results of Isolated Liver Perfusion with Cytotoxics in Metastases from Colorectal Primary

Aigner, Karl Reinhard; Walther, H; Tonn, Jörg‐Christian; A, Wenzl; Hechtel, R.; Merker, G; Schwemmle, K

doi:10.1007/978-3-642-82025-0_18

Cited by 39 publications

(16 citation statements)

References 2 publications

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“…Ausman and Aust reported on liver perfusion in 196012; they were followed by Mulcare and colleagues in 1973.13 Aigner and colleagues, in 1983, simplified and expanded the use ofliver perfusion. 14 With the introduction of hyperthermia for perfusion, …”

Section: Techniquesmentioning

confidence: 99%

Regional Chemotherapy for Melanoma A 35-Year Experience

et al. 1994

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ObjectiveThe authors present their 35-year experience with intra-arterial chemotherapeutic regionai perfusion of 1 139 patients with melanomas, using an extracorporeal oxygenated circuft and heart-lung apparatus. Summary Background DataIntra-arterial chemotherapy produces improved responses in many tumors. By isolating and sustaining the area with extracorporeal oxygenated circulation, high doses can be delivered to the tumor area, limited only by local toxicity. Drug levels up to 10 times those achieved by systemic administration are obtained. MethodsTechniques for hyperthermic perfusion were developed for limbs, pelvis, head, neck, and skin of the breast. Melphalan (Burroughs Wellcome, Research Triangle Park, NC) was used in 753 patients. Combinations with melphalan or other drugs were used in remaining cases at temperature of 38 to 40 C for 30 to 60 minutes. ResultsChemotherapy perfusion followed by tumor excision or node dissection, was performed where indicated. The cumulative 1 0-year survival for patients with localized melanomas was 70%. For patients with local recurrences or satellites within 3 cm, survival was 61 %. For those with regionally confined intransit tumors, survival was 30%; for those with regional node involvement, 38%; for those with intransit and nodal metastases, 16%; for those with distant metastases and perfusion-mainly to save functional limbs-survival was 7%. Multiple perfusions were performed in 158 patients with recurrent disease on 366 occasions. Patients with indolent regionally confined melanomas were benefited by prolongation of useful life. ConclusionsSafe perfusion techniques are available for most anatomic regions. Increased chemotherapeutic doses are delivered to isolated areas limited only by local toxicity. Adjunct perfusion in poor prognosis stage cases is useful in reducing local recurrence, and intransit or lymph node metastases. Regional perfusion reduces the need for major amputation. Multiple perfusion can be useful in treating recurrent chronic melanoma. 520

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Section: Techniquesmentioning

confidence: 99%

Regional Chemotherapy for Melanoma A 35-Year Experience

et al. 1994

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“…6,7,16 Because of the changing strategies in the treatment of CRC, finding evidence of distant metastases is of vital importance. 4,[17][18][19] After curative resection, the stage and nature of the tumor (DNAploidy) play major roles in determining adjuvant treatment. 6,7,20,21 Despite techological advances in the screening methods of radiology, immunology, and genetics, their clinical use is still limited, due to the considerable costs involved.…”

Section: Discussionmentioning

confidence: 99%

Carcinoembryonic Antigen to Detect Hepatic Metastases of Colorectal Cancers

et al. 2003

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“…Desde entonces, se ha utilizado exitosamente en el tratamiento de las neoplasias de localización en las extremidades, como los sarcomas de tejidos blandos y el melanoma [6][7][8][9][10][11] , aunque también se ha descrito en tumores de otra localización como el hígado, el estómago y colon, la pelvis, la región maxilofacial, y la cabeza y cuello [12][13][14][15][16] . En la actualidad, no sólo se perfunden agentes quimioterápicos (v.…”

Section: Introductionunclassified

Consideraciones perioperatorias en el paciente oncológico sometido a perfusión aislada de la extremidad

Cuéllar-Guzmán¹,

Ferretiz-López²,

Cárdenas-Herrera³

2022

GAMO

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Gaceta Mexicana de Oncologia. 2017;16(5):289-294 Resumen La perfusión aislada de la extremidad (PAE) y la perfusión hipertérmica aislada de la extremidad (PHAE) son procedimientos utilizados para el tratamiento de diversos tumores localizados en las extremidades (primordialmente melanoma y tumores de tejidos blandos), inducen una elevada tasa de respuesta tumoral y se asocian a una elevada tasa de salvamento de la extremidad, representando una alternativa a la amputación. Se trata de procedimientos complejos y con una elevada dificultad técnica que requieren del esfuerzo de todo un equipo multidisciplinario (cirujano, anestesiólogo, enfermera, perfusionista e intensivista). Los cambios hemodinámicos, la fuga de los fármacos a través de vasos colaterales, su toxicidad local y sistémica, así como las potenciales complicaciones, requieren de la monitorización continua e invasiva durante el procedimiento y de una estrecha vigilancia posquirúrgica. El propósito de este artículo de revisión fue analizar las pautas para el abordaje perioperatorio del paciente oncológico que se somete a este procedimiento. (creativecommons.org/licenses/by-nc-nd/4.0/). abstract Isolated limb perfusion (ILP) and hyperthermic ILP (HILP) are therapeutic options for patients with unresectable malignancies in the extremities (e.g. primarily melanoma and soft tissue tumors), they induce a high rate of tumor response; associates with high limb salvage rates and represents an effective alternative to amputation. These are challenging procedures with a high technical difficulty that require the efforts of a multidisciplinary team (surgeon, anesthesiologist, nurse, perfusionist and intensivist). Hemodynamic changes, drug leakage through collateral vessels, local and systemic toxicity, and potential complications require continuous and invasive monitoring during the procedure and rigorous post-surgical monitoring. The purpose of this review article was to update the strategies for the perioperative care of cancer patients undergoing this procedure.

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First Experimental and Clinical Results of Isolated Liver Perfusion with Cytotoxics in Metastases from Colorectal Primary

Cited by 39 publications

References 2 publications

Regional Chemotherapy for Melanoma A 35-Year Experience

Regional Chemotherapy for Melanoma A 35-Year Experience

Carcinoembryonic Antigen to Detect Hepatic Metastases of Colorectal Cancers

Consideraciones perioperatorias en el paciente oncológico sometido a perfusión aislada de la extremidad

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