TREATMENT FOR MELANOMA OF THE LOWER-EXTREMITY WITH INTRA-LESIONAL INJECTION OF BACILLE CALMETTE GUERIN AND HYPERTHERMIC PERFUSION

  • 1 January 1979
    • journal article
    • research article
    • Vol. 149  (1) , 17-21
Abstract
Patients (27) with locally recurrent melanoma of the lower extremity were treated during a 6 yr period. Recurrences were noted with primary lesions, at Clark''s level II, III, IV or V, greater than 1.7 mm in depth of invasion and included intransit metastases, satellitosis, s.c. metastases and combinations of the 3. Median time to recurrence was 12-14 mo. whether or not lymphadenectomy had been performed or lymph node metastases were present. Local recurrence was treated initially with intratumor BCG; 20 of 27 patients had complete or transient disease control and 14 patients were alive at 1.5-55.0 mo. More responders reacted to dinitrochlorobenzene and purified protein derivative skin tests, although these parameters did not predict response to therapy. If intratumor BCG therapy did not control local disease or if the disease progressed toward the upper 3rd of the thigh, patients underwent hyperthermic perfusion with L-phenylalanine mustard. Nine patients underwent 10 therapeutic perfusions with objective response in 7 of 9, with 5 being alive at 2-65 mo. Intratumor BCG therapy and subsequent hyperthermic perfusion in BCG failures are rational treatment alternatives for locally recurrent melanomas of the extremity.

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