In a nutshell
The authors assessed the role of amputation (removal) in the management of melanoma in limbs (arms or legs).
Some background
There are many treatment options available for patients with limb melanoma. Isolated limb perfusion (ILP) is one of the most common and effective treatments for limb melanoma. In ILP, high doses of chemotherapy can be given directly into the melanoma-affected limb. However, occasionally, patients have resistance to ILP or have other disease conditions not suitable for ILP. Major amputation (surgical removal of affected limb) could be beneficial in such cases. Based on several studies, long-term survival occurred in 15-35% of patients undergoing major amputations.
The indications and outcomes of amputation in melanoma need to be further evaluated to have a better understanding of the benefits of this procedure
Methods & findings
The authors aimed to review the indications and benefits of major amputation in advanced limb melanoma.
51 patients were included in this study. 55 major amputations were performed on these patients. Out of these 17 amputations were on arms and 38 were on legs.
Indications
67% of patients had cancer spread to surrounding lymph nodes (important part of blood circulation). 14% had spread of cancer to distant body parts. 14% had pain or ulceration (tumor breaking through skin’s surface) after regional (at the site of tumor) chemotherapy. Overall, 58% had regional chemotherapy before amputation.
Outcome
The 5-year overall survival (patients still alive after treatment) from the time of amputation was 22.8%. For those patients who had cancer spread to lymph nodes, or had local relapse of disease, the 5-year overall survival after amputation was 38.4%.
The bottom line
The authors concluded that major amputation could be beneficial for advanced limb melanoma patients where other treatments had already been used without high success.
Published By :
Annals of Surgical Oncology
Date :
Feb 25, 2015
