Main description:

The indications and results of isolated limb perfusion have varied over the years and are now mostly limited to unresectable melanoma and soft tissue sarcoma of the extremities. This thesis gives an overview of the current applications of isolated limb perfusion and answers a number of questions that have arisen regarding the practice of isolated limb perfusion. The principle aim of this thesis was to determine which patients should (or should not be) advised to undergo isolated limb perfusion, on the basis of 23 years of experience with isolated limb perfusion in the Antoni van Leeuwenhoek hospital/The Netherlands Cancer Institute and the Daniel den Hoed Cancer Center (Rotterdam). Secondly, the aim was to determine the most effective schedule and to describe the results that can be expected of isolated limb perfusion in terms of response, recurrence-free survival, overall survival and the long term quality of these patients' lives. This title is available in the OAPEN Library - http://www.oapen.org.

Contents:

Table of Contents - 8 1. Introduction and outline of the thesis - 10 2. Isolated limb perfusion: what is the evidence for its use? - 18 3. Isolated limb perfusion for unresectable melanoma of the extremities - 32 4. Isolated limb perfusion prolongs the limb recurrence-free interval after several episodes of excisional surgery for locoregional recurrent melanoma - 44 5. Safety and efficacy of isolated limb perfusion in elderly melanomia patients - 58 (Editorial) Isolated Limb Perfusion in Elderly Melanomia Patients - 70 6. Repeat isolated limb perfusion with TNFa and melphalan for recurrent limb melanoma after failure of previous perfusion - 72 7. Prognostic factors for poor survival after isolated limb perfusion: criteria for patient selection? - 84 8. Long-term results of a double perfusion schedule using high-dose hypertermia and melphalan sequentially in extensive melanoma of the lower limb - 94 9. Quality of life in long-term survivors of isolated limb perfusion for melanoma of the limbs - 104 10. Isolated limb perfusion with TNF-a and melphalan for unresectable soft tissue sarcoma of the extremities - 116 11. Isolated limb perfusion with melphalan for femoral metastases of breast cancer: case report - 128 12. Summary and conclusions/Samenvatting en conclusies - 134 Appendix.Regionale isolatieperfusie: ook bij bejaarde patienten goed toepasbaar (Dutch) - 142 Dankwoord (Dutch) - 150 Curriculum Vitae (Dutch) - 153