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Alexander M.m. Eggermont - One of the best experts on this subject based on the ideXlab platform.
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Repeated isolated Limb Perfusion in melanoma patients with recurrent in-transit metastases.
Melanoma research, 2015Co-Authors: Jan P. Deroose, Alexander M.m. Eggermont, Dirk J. Grünhagen, Cornelis VerhoefAbstract:textabstractIn-transit metastases of melanoma occur in 5-8% of all melanoma patients. In case of extensive locoregional disease, Tumor necrosis factor-α and melphalan-based isolated Limb Perfusion (TM-ILP) had proven to yield excellent local control. Here, we report on repeat TM-ILP for locoregional recurrence after isolated Limb Perfusion. Between 1991 and 2013, 37 consecutive repeat TM-ILPs were analyzed in 32 different patients. Three patients underwent a third TM-ILP. During a median follow-up of 20 months after repeat TM-ILP, the overall response rate was 86%. Complete response (CR) was recorded after 24 TM-ILPs (65%). CR after first TM-ILP was a strong predictor for successful repeat TM-ILP in terms of clinical response and local recurrence. Local toxicity was mild (70% Wieberdink I-II). The local recurrence rate was 59%. Five-year overall survival was 35%. Repeat TM-ILP is a safe treatment modality in melanoma patients with recurrent in-transit metastases of melanoma. Those with a CR after first TM-ILP benefit the most from repeat TM-ILP.
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20 years experience of tnf based isolated Limb Perfusion for in transit melanoma metastases tnf dose matters
Annals of Surgical Oncology, 2012Co-Authors: Jan P. Deroose, Alexander M.m. Eggermont, Albertus N. Van Geel, Johannes H.w. De Wilt, Jacobus W A Burger, Cornelis VerhoefAbstract:Background Approximately 5–8% of melanoma patients will develop in-transit metastases (IT-mets). Tumor necrosis factor-α (TNF) and melphalan-based isolated Limb Perfusion (TM-ILP) is an attractive treatment modality in melanoma patients with multiple IT-mets. This study reports on a 20 years experience and outlines the evolution and major changes since the introduction of TNF in ILP.
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treatment of melanoma metastases in a Limb by isolated Limb Perfusion and isolated Limb infusion
Journal of Surgical Oncology, 2011Co-Authors: Alessandro Testori, Alexander M.m. Eggermont, Cornelis Verhoef, Hidde M Kroon, Elisabetta Pennacchioli, Mark B Faries, John F. ThompsonAbstract:In-transit melanoma metastases are often confined to a Limb. In this circumstance, treatment by isolated Limb Perfusion or isolated Limb infusion can be a remarkably effective regional treatment option.
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Treatment of melanoma metastases in a Limb by isolated Limb Perfusion and isolated Limb infusion.
Journal of Surgical Oncology, 2011Co-Authors: Alessandro Testori, Alexander M.m. Eggermont, Cornelis Verhoef, Hidde M Kroon, Elisabetta Pennacchioli, Mark B Faries, John F. ThompsonAbstract:In-transit melanoma metastases are often confined to a Limb. In this circumstance, treatment by isolated Limb Perfusion or isolated Limb infusion can be a remarkably effective regional treatment option. J. Surg. Oncol. 2011; 104:397–404. © 2011 Wiley-Liss, Inc.
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Isolated Limb Perfusion for Melanoma in Transit Metastases
Regional Cancer Therapy, 2007Co-Authors: Flavia Brunstein, Dirk J. Grünhagen, Timo L.m. Ten Hagen, Alexander M.m. EggermontAbstract:The treatment of melanoma in transit metastases can vary widely and is dependent on the size and number of lesions. When many, large lesions exist, isolated Limb Perfusion (ILP) can be used as an attractive treatment option with high response rates. We review here the various methods of treatment for melanoma in transit metastases, with a focus on ILP. Indications and results are discussed, and the extra value of tumour necrosis factor (TNF) is evaluated. ILP with melphalan results in complete response rates of 40 to 82% (54% in a large retrospective metaanalysis). The addition of TNF can improve these complete response rates (59–85%), and although no data from randomized controlled trials are available, TNF seems of particular value in large, bulky lesions or in patients with recurrent disease after previous ILP. TNF-based ILP has earned a permanent place in the treatment of patients with melanoma it transit metastases. In patients with a high tumor burden, TNF-based ILP is the most efficacious procedure to obtain local control and achieve Limb salvage.
John F. Thompson - One of the best experts on this subject based on the ideXlab platform.
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treatment of melanoma metastases in a Limb by isolated Limb Perfusion and isolated Limb infusion
Journal of Surgical Oncology, 2011Co-Authors: Alessandro Testori, Alexander M.m. Eggermont, Cornelis Verhoef, Hidde M Kroon, Elisabetta Pennacchioli, Mark B Faries, John F. ThompsonAbstract:In-transit melanoma metastases are often confined to a Limb. In this circumstance, treatment by isolated Limb Perfusion or isolated Limb infusion can be a remarkably effective regional treatment option.
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Treatment of melanoma metastases in a Limb by isolated Limb Perfusion and isolated Limb infusion.
Journal of Surgical Oncology, 2011Co-Authors: Alessandro Testori, Alexander M.m. Eggermont, Cornelis Verhoef, Hidde M Kroon, Elisabetta Pennacchioli, Mark B Faries, John F. ThompsonAbstract:In-transit melanoma metastases are often confined to a Limb. In this circumstance, treatment by isolated Limb Perfusion or isolated Limb infusion can be a remarkably effective regional treatment option. J. Surg. Oncol. 2011; 104:397–404. © 2011 Wiley-Liss, Inc.
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Long-term results of hyperthermic, isolated Limb Perfusion for melanoma: a reflection of tumor biology.
Annals of surgery, 2007Co-Authors: Amira Sanki, Peter Kam, John F. ThompsonAbstract:Purpose:To review the long-term duration of Limb tumor complete remission (CR) and patient survival following therapeutic hyperthermic isolated Limb Perfusion (ILP) with cytotoxic drugs for melanoma.Methods:A retrospective case series of 124 ILPs performed in 111 patients.Results:There were 120 asse
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Anaesthetic experience with isolated Limb Perfusion with melphalan for melanoma
Perfusion, 1996Co-Authors: Pca Kam, John F. ThompsonAbstract:Hyperthermic isolated Limb Perfusion (ILP) with melphalan is an accepted method of treatment for advanced or recurrent melanoma on a Limb. In a review of 124 patients who underwent 130 ILPs at the Sydney Melanoma Unit, the anaesthetic considerations are summarized. All patients received general anaesthesia. The level of monitoring is discussed and monitoring of the Limb venous pressure is important to minimize major fluid shifts between the systemic vasculature and the vascular compartment of the isolated Limb and extracorporeal circuit.
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Isolated Limb Perfusion with urokinase in the treatment of extensive vascular thrombosis of the lower Limbs.
Perfusion, 1994Co-Authors: Pca Kam, John F. Thompson, J. MayAbstract:Isolated Limb Perfusion with urokinase was used in combination with balloon catheter embolectomy in three patients with extensive vascular thrombosis in the lower Limbs after conventional methods of treatment failed to restore Perfusion to the lower Limb. The technique and its results are described and discussed. It is suggested that isolated Limb Perfusion with urokinase is safe and is worthy of further investigation in the treatment of critically ischaemic lower Limbs.
Cornelis Verhoef - One of the best experts on this subject based on the ideXlab platform.
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Repeated isolated Limb Perfusion in melanoma patients with recurrent in-transit metastases.
Melanoma research, 2015Co-Authors: Jan P. Deroose, Alexander M.m. Eggermont, Dirk J. Grünhagen, Cornelis VerhoefAbstract:textabstractIn-transit metastases of melanoma occur in 5-8% of all melanoma patients. In case of extensive locoregional disease, Tumor necrosis factor-α and melphalan-based isolated Limb Perfusion (TM-ILP) had proven to yield excellent local control. Here, we report on repeat TM-ILP for locoregional recurrence after isolated Limb Perfusion. Between 1991 and 2013, 37 consecutive repeat TM-ILPs were analyzed in 32 different patients. Three patients underwent a third TM-ILP. During a median follow-up of 20 months after repeat TM-ILP, the overall response rate was 86%. Complete response (CR) was recorded after 24 TM-ILPs (65%). CR after first TM-ILP was a strong predictor for successful repeat TM-ILP in terms of clinical response and local recurrence. Local toxicity was mild (70% Wieberdink I-II). The local recurrence rate was 59%. Five-year overall survival was 35%. Repeat TM-ILP is a safe treatment modality in melanoma patients with recurrent in-transit metastases of melanoma. Those with a CR after first TM-ILP benefit the most from repeat TM-ILP.
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20 years experience of tnf based isolated Limb Perfusion for in transit melanoma metastases tnf dose matters
Annals of Surgical Oncology, 2012Co-Authors: Jan P. Deroose, Alexander M.m. Eggermont, Albertus N. Van Geel, Johannes H.w. De Wilt, Jacobus W A Burger, Cornelis VerhoefAbstract:Background Approximately 5–8% of melanoma patients will develop in-transit metastases (IT-mets). Tumor necrosis factor-α (TNF) and melphalan-based isolated Limb Perfusion (TM-ILP) is an attractive treatment modality in melanoma patients with multiple IT-mets. This study reports on a 20 years experience and outlines the evolution and major changes since the introduction of TNF in ILP.
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treatment of melanoma metastases in a Limb by isolated Limb Perfusion and isolated Limb infusion
Journal of Surgical Oncology, 2011Co-Authors: Alessandro Testori, Alexander M.m. Eggermont, Cornelis Verhoef, Hidde M Kroon, Elisabetta Pennacchioli, Mark B Faries, John F. ThompsonAbstract:In-transit melanoma metastases are often confined to a Limb. In this circumstance, treatment by isolated Limb Perfusion or isolated Limb infusion can be a remarkably effective regional treatment option.
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Treatment of melanoma metastases in a Limb by isolated Limb Perfusion and isolated Limb infusion.
Journal of Surgical Oncology, 2011Co-Authors: Alessandro Testori, Alexander M.m. Eggermont, Cornelis Verhoef, Hidde M Kroon, Elisabetta Pennacchioli, Mark B Faries, John F. ThompsonAbstract:In-transit melanoma metastases are often confined to a Limb. In this circumstance, treatment by isolated Limb Perfusion or isolated Limb infusion can be a remarkably effective regional treatment option. J. Surg. Oncol. 2011; 104:397–404. © 2011 Wiley-Liss, Inc.
Andrew J. Hayes - One of the best experts on this subject based on the ideXlab platform.
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Isolated Limb Perfusion with Melphalan and Tumour Necrosis Factor α for In-Transit Melanoma and Soft Tissue Sarcoma.
Annals of Surgical Oncology, 2015Co-Authors: Henry G. Smith, J. Cartwright, Michelle J. Wilkinson, Dirk C. Strauss, Janet Thomas, Andrew J. HayesAbstract:Background Isolated Limb Perfusion (ILP) is indicated in locally advanced melanoma and soft tissue sarcoma of the extremities. This series reports the outcome of patients undergoing ILP with melphalan and tumour necrosis factor α (TNFα) at a single centre.
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isolated Limb Perfusion with melphalan and tumor necrosis factor alpha for advanced melanoma and soft tissue sarcoma
Annals of Surgical Oncology, 2006Co-Authors: Andrew J. Hayes, Susan J Neuhaus, M A Clark, Meirion J ThomasAbstract:Background Isolated Limb Perfusion (ILP) with melphalan is used in the treatment of advanced in-transit melanoma but has no real efficacy for irresectable soft tissue sarcomas arising in the extremities. The addition of tumor necrosis factor (TNF)-α may increase response rates for bulky melanoma and for sarcoma, but the potential for major systemic toxicity has limited its use.
Harald J. Hoekstra - One of the best experts on this subject based on the ideXlab platform.
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Quality of Life After Hyperthermic Isolated Limb Perfusion for Locally Advanced Extremity Soft Tissue Sarcoma
Annals of surgical oncology, 2006Co-Authors: Katja M. J. Thijssens, Robert J. Van Ginkel, Josette E. H. M. Hoekstra-weebers, Harald J. HoekstraAbstract:Background Quality of life (QoL) and posttraumatic stress symptoms (PTSS) were studied in patients with soft tissue sarcoma (STS) of the extremities treated with isolated Limb Perfusion and delayed resection, with or without adjuvant irradiation.
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isolated Limb Perfusion with tumor necrosis factor α and melphalan for locally advanced soft tissue sarcoma the value of adjuvant radiotherapy
Annals of Surgical Oncology, 2006Co-Authors: Katja M. J. Thijssens, Elisabeth Pras, Robert J. Van Ginkel, Albert J H Suurmeijer, Harald J. HoekstraAbstract:Background The aim was to investigate the value of adjuvant radiotherapy for locally advanced soft tissue sarcoma after hyperthermic isolated Limb Perfusion (ILP) with tumor necrosis factor α and melphalan followed by Limb-saving surgery.
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Isolated Limb Perfusion: The European Experience
Surgical oncology clinics of North America, 2001Co-Authors: Ferdy Lejeune, Danielle Liénard, Bin B. R. Kroon, Franco Di Filippo, Harald J. Hoekstra, Mario Santinami, Alexander M.m. EggermontAbstract:Isolated Limb Perfusion (ILP) is a method of cancer treatment allowing the administration of high doses of anticancer agents in a Limb surgically isolated from systemic circulation. By using continuous leakage monitoring and using the drug melphalan, a high complete remission rate is obtained in patients with melanoma. In patients with sarcomas, ILP with tumor necrosis factor and melphalan represents a neoadjuvant treatment for Limb-sparing surgery. This treatment is the first demonstration of an active anti-angiogenic regimen in the clinic.
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Isolated Limb Perfusion of an irradiated foot with tumor necrosis factor, interferon, and melphalan
Archives of surgery (Chicago Ill. : 1960), 1996Co-Authors: Robert J. Van Ginkel, Harald J. Hoekstra, Alex M. M. Eggermont, Elisabeth Pras, Heimen Schraffordt KoopsAbstract:A 57-year-old woman presented with the second recurrence of a high-grade malignant fibrous histiocytoma of the right foot, following previous local resection plus curative adjuvant radiotherapy. The first recurrence of the lesion was treated by isolated Limb Perfusion with cisplatin; the second recurrence was treated by isolated Limb Perfusion with tumor necrosis factor, interferon, and melphalan. The tumor and the area that had been irradiated showed a bluish color a few hours after tumor necrosis factor Perfusion. Amputation of the right foot and leg below the knee had to be performed because of severe necrosis. ( Arch Surg. 1996;131:672-674 )
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Hyperthermic isolated Limb Perfusion with cisplatin in four patients with sarcomas of soft tissue and bone
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 1996Co-Authors: Robert J. Van Ginkel, Heimen Schraffordt Koops, Elisabeth G.e. De Vries, Willemina M. Molenaar, Donald R. A. Uges, Harald J. HoekstraAbstract:The value of hyperthermic isolated Limb Perfusion (HILP) with cisplatin in the management of locally advanced soft tissue sarcomas or metastatic bone sarcoma was studied. Four patients were treated with HILP under mild hyperthermia (39–40°C) with 20–30 mg cisplatin/l perfused Limb volume. Toxicity in the perfused Limbs was moderate, and the erythema and oedema that occurred resolved spontaneously within 7–14 days as did the slight motor and sensory neuropathy over a longer period of time. Clinically, a reduction of pain was observed in all patients. Two weeks after Perfusion, tumour biopsies were taken to evaluate tumour response. Two patients showed a pathological complete response, one patient showed >90% necrosis and one patient showed no response. Currently patients are treated with tumour necrosis factor and melphalan as Perfusion agents. The above-mentioned results make the combination of tumour necrosis factor with cisplatin in the isolated Limb Perfusion setting an interesting option.