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1. Kadir AR: Burn scar neoplasm. Ann Burns Fire Disasters; 2007 Dec 31;20(4):185-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Burn scar neoplasm.
  • Marjolin's ulcer is a rare and aggressive cutaneous malignancy that occurs in previously traumatized and chronically inflamed skin, especially after burns.
  • The mean age at tumour diagnosis was 40 yr and the ratio of male to female was 2:1 (67% males and 33% female).
  • The scalp was most frequently affected (16 patients = 33.3%), followed by the lower limb (14 patients = 29.1%).
  • Treatment of the neoplasm consisted of excision and grafting in 36 patients (75.0%), excision and reconstruction with flaps in eight patients (16.6%), and amputation in three patients (6.2%).
  • A chemotherapy combination of the above treatments was used in two patients (4.1%).

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  • (PMID = 21991095.001).
  • [ISSN] 1592-9558
  • [Journal-full-title] Annals of burns and fire disasters
  • [ISO-abbreviation] Ann Burns Fire Disasters
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Other-IDs] NLM/ PMC3188084
  • [Keywords] NOTNLM ; BURN / NEOPLASM / SCAR
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2. Di Filippo F, Rossi CR, Santinami M, Cavaliere F, Garinei R, Anzà M, Perri P, Botti C, Di Angelo P, Pasqualoni R, Di Filippo S: Hyperthermic isolation limb perfusion with TNFalpha in the treatment of in-transit melanoma metastasis. In Vivo; 2006 Nov-Dec;20(6A):739-42
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  • [Title] Hyperthermic isolation limb perfusion with TNFalpha in the treatment of in-transit melanoma metastasis.
  • BACKGROUND: Hyperthermic isolation limb perfusion (HILP) with tumor necrosis factor alpha (TNFalpha) and IFNgamma was pioneered by Liénard and Lejeune in 1988.
  • The TNFalpha was empirically employed at a dosage of 3-4 mg, that is ten times the systemic maximum tolerated dose (MTD).
  • All the patients were submitted to HILP via axillary and iliac vessels for tumor of upper and lower limb, respectively.
  • TNFalpha was injected in the extracorporal circuit at the pre-established dose, followed after 30 minutes by melphalan (13 and 10 mg/L of limb volume for upper and lower limbs, respectively).
  • RESULTS: A grade 1 and 2 limb toxicity was found in 52.9% and 30.1% of the patients, respectively, 5.5% of patients exhibited a grade 3 and 4, whereas grade 5 limb toxicity was not found.
  • [MeSH-major] Hyperthermia, Induced. Melanoma / therapy. Skin Neoplasms / therapy. Tumor Necrosis Factor-alpha / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents, Alkylating / administration & dosage. Chemotherapy, Cancer, Regional Perfusion. Combined Modality Therapy. Drug Therapy, Combination. Extremities. Female. Humans. Male. Melphalan / administration & dosage. Middle Aged. Neoplasm Staging

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  • (PMID = 17203758.001).
  • [ISSN] 0258-851X
  • [Journal-full-title] In vivo (Athens, Greece)
  • [ISO-abbreviation] In Vivo
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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3. Poulsen MG, Rischin D, Porter I, Walpole E, Harvey J, Hamilton C, Keller J, Tripcony L: Does chemotherapy improve survival in high-risk stage I and II Merkel cell carcinoma of the skin? Int J Radiat Oncol Biol Phys; 2006 Jan 1;64(1):114-9
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  • [Title] Does chemotherapy improve survival in high-risk stage I and II Merkel cell carcinoma of the skin?
  • PURPOSE: The effectiveness of synchronous carboplatin, etoposide, and radiation therapy in improving survival was evaluated by comparison of a matched set of historic control subjects with patients treated in a prospective Phase II study that used synchronous chemotherapy and radiation and adjuvant chemotherapy.
  • PATIENTS AND METHODS: Patients were included in the analysis if they had disease localized to the primary site and nodes, and they were required to have at least one of the following high-risk features: recurrence after initial therapy, involved nodes, primary size greater than 1 cm, or gross residual disease after surgery.
  • All patients who received chemotherapy were treated in a standardized fashion as part of a Phase II study (Trans-Tasman Radiation Oncology Group TROG 96:07) from 1997 to 2001.
  • Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks, and synchronous carboplatin (AUC 4.5) and etoposide, 80 mg/m(2) i.v. on Days 1 to 3, were given in Weeks 1, 4, 7, and 10.
  • Because of imbalances in the prognostic variables between the two treatment groups, comparisons were made by application of Cox's proportional hazard modeling.
  • RESULTS: Of the 102 patients who had high-risk Stage I and II disease, 40 were treated with chemotherapy (TROG 96:07) and 62 were treated without chemotherapy (historic control subjects).
  • Primary site on the lower limb had an adverse effect on locoregional control.
  • CONCLUSIONS: The multivariate analysis suggests chemotherapy has no effect on survival, but because of the wide confidence limits, a chemotherapy effect cannot be excluded.
  • A study of this size is inadequately powered to detect small improvements in survival, and a larger randomized study remains the only way to truly confirm whether chemotherapy improves the results in high-risk MCC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Merkel Cell / drug therapy. Carcinoma, Merkel Cell / mortality. Skin Neoplasms / drug therapy. Skin Neoplasms / mortality
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Epidemiologic Methods. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Neoplasm Staging. Neoplasm, Residual. Prognosis. Radiotherapy Dosage

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  • (PMID = 16125873.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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4. Poulsen M, Round C, Keller J, Tripcony L, Veness M: Factors influencing relapse-free survival in Merkel cell carcinoma of the lower limb--a review of 60 cases. Int J Radiat Oncol Biol Phys; 2010 Feb 1;76(2):393-7
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  • [Title] Factors influencing relapse-free survival in Merkel cell carcinoma of the lower limb--a review of 60 cases.
  • PURPOSE: Factors affecting relapse-free survival (RFS) in patients with Merkel cell carcinoma (MCC) of the lower limb were reviewed.
  • METHODS AND MATERIALS: The records of 60 patients from 1986 to 2005 with a diagnosis of MCC of the lower limb or buttock were retrospectively reviewed.
  • The patients were treated with curative intent with surgery, radiation, or chemotherapy.
  • Elective treatment should be given to the inguinal nodes to reduce the risk of relapse.
  • [MeSH-major] Carcinoma, Merkel Cell / mortality. Lower Extremity. Neoplasm Recurrence, Local / mortality. Skin Neoplasms / mortality

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  • [Copyright] Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.
  • (PMID = 19515508.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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5. Noorda EM, Vrouenraets BC, Nieweg OE, Kroon BB: Isolated limb perfusion in regional melanoma. Surg Oncol Clin N Am; 2006 Apr;15(2):373-84
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  • [Title] Isolated limb perfusion in regional melanoma.
  • Randomized studies are needed to further establish the role of perfusion as an adjuvant treatment for resectable recurrences of melanoma.
  • Unresectable limb melanoma is the primary indication for perfusion.
  • The long-term health-related quality of life of survivors of melanoma who underwent treatment with perfusion is comparable to that of their healthy peers in the general Dutch population.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion. Lower Extremity. Melanoma / drug therapy. Perfusion. Skin Neoplasms / drug therapy. Upper Extremity
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / prevention & control. Neoplasm Staging

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  • (PMID = 16632221.001).
  • [ISSN] 1055-3207
  • [Journal-full-title] Surgical oncology clinics of North America
  • [ISO-abbreviation] Surg. Oncol. Clin. N. Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 50
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6. Paramo JC, Benavides C, Tang LW, Martinez A, Cabello-Inchausti B, Davila E, Mesko TW: Complete remission of previously intractable peripheral cutaneous T-cell lymphoma of the lower extremity using isolated hyperthermic limb perfusion with melphalan (1-phenylalanine mustard). Cancer Invest; 2004;22(4):545-9
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  • [Title] Complete remission of previously intractable peripheral cutaneous T-cell lymphoma of the lower extremity using isolated hyperthermic limb perfusion with melphalan (1-phenylalanine mustard).
  • After chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), she went into remission for 2 years before relapse of her PCTCL localized to the right lower extremity.
  • Persistent isolated disease in the extremity since then led to numerous chemotherapy regimens and localized radiation therapy.
  • Due to dramatic limb threatening progression of the disease in 2001, she underwent isolated hyperthermic limb perfusion with melphalan (1-phenylalanine mustard).
  • Although limb preservation could not be achieved, this treatment resulted in complete clinical and pathological regression of the lesions of the perfused extremity.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Hyperthermia, Induced / methods. Lower Extremity. Lymphoma, T-Cell, Cutaneous / therapy. Melphalan / administration & dosage. Skin Neoplasms / therapy
  • [MeSH-minor] Aged. Amputation. Chemotherapy, Cancer, Regional Perfusion. Combined Modality Therapy. Female. Humans. Neoplasm Metastasis. Neoplasm Recurrence, Local


7. Ponte P, Moniz JV, Farricha V, Weinholtz JB: Merkel cell carcinoma: an unusual indication for isolated limb perfusion. Dermatol Online J; 2008;14(7):6
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  • [Title] Merkel cell carcinoma: an unusual indication for isolated limb perfusion.
  • Isolated limb perfusion (ILP) is a surgical technique that enables the administration of high-dose chemotherapy while minimizing serious systemic side effects.
  • The clinical value and indications are well established for skin and soft tissue tumors on limbs.
  • For skin tumors, this technique is mainly indicated for melanoma with in-transit metastasis.
  • For soft tissue tumors--sarcoma and osteosarcoma--it is useful as a palliative technique to reduce the tumoral mass.
  • Limb perfusion can also be an option in other tumors, such as advanced stage squamous cell carcinoma or Merkel cell carcinoma.
  • We present a case report of a 68-year-old man with Merkel cell carcinoma on the right tibiotarsical region, with in-transit metastasis throughout the whole lower limb.
  • Regional chemotherapy involving ILP with melphalan and tumor necrosis factor-alpha (TNFalpha) was performed in order to avoid amputation; the primary tumor was not excised.
  • Although there was no change in the patient's prognosis, ILP was able to avoid limb amputation as it controlled local-regional disease and produced complete regional remission.
  • The addition of TNFalpha to melphalan in ILP appears to produce greater efficacy in the treatment of patients with bulky tumors or a large number of in-transit metastases.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Merkel Cell / drug therapy. Carcinoma, Merkel Cell / secondary. Chemotherapy, Cancer, Regional Perfusion / methods. Skin Neoplasms / drug therapy. Skin Neoplasms / pathology
  • [MeSH-minor] Aged. Biopsy, Needle. Fatal Outcome. Follow-Up Studies. Humans. Immunohistochemistry. Limb Salvage / methods. Lower Extremity. Male. Melphalan / administration & dosage. Neoplasm Metastasis. Neoplasm Staging. Palliative Care / methods. Risk Assessment. Treatment Outcome. Tumor Necrosis Factor-alpha / administration & dosage

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  • (PMID = 18718190.001).
  • [ISSN] 1087-2108
  • [Journal-full-title] Dermatology online journal
  • [ISO-abbreviation] Dermatol. Online J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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8. Roberts MS, Wu ZY, Siebert GA, Anissimov YG, Thompson JF, Smithers BM: Pharmacokinetics and pharmacodynamics of melphalan in isolated limb infusion for recurrent localized limb malignancy. Melanoma Res; 2001 Aug;11(4):423-31
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  • [Title] Pharmacokinetics and pharmacodynamics of melphalan in isolated limb infusion for recurrent localized limb malignancy.
  • Isolated limb infusion (ILI) is an attractive, less complex alternative to isolated limb perfusion (ILP).
  • It has a lower morbidity in treating localized recurrences and in transit metastases of the limb for tumours such as melanoma, Merkel cell tumour and Kaposi's sarcoma, allowing administration of high concentrations of cytotoxic agent to the affected limb under hypoxic conditions.
  • Melphalan is the preferred cytotoxic agent for the treatment of melanoma by ILP or ILI.
  • We report pharmacokinetic data from 12 patients treated by ILI for tumours of the limb in Brisbane.
  • The kinetics of drug distribution in the limb was calculated using a two-compartment vascular model, where both tissue and infusate act as well-stirred compartments.
  • Recirculation and wash-out flow rates, tissue concentrations and the permeability surface area product (PS) were calculated.
  • Correlations between the PS value and the drug concentrations in the perfusate and tissue were supported by the results.
  • These data contribute to a better understanding of the distribution of melphalan during ILI in the limb, and offer the opportunity to optimize the drug regimen for patients undergoing ILI.
  • [MeSH-major] Infusion Pumps. Leg. Melphalan / pharmacokinetics. Melphalan / therapeutic use. Neoplasm Recurrence, Local / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Aged. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / pharmacokinetics. Antineoplastic Agents, Alkylating / therapeutic use. Carcinoma, Merkel Cell / drug therapy. Carcinoma, Merkel Cell / pathology. Dose-Response Relationship, Drug. Female. Humans. Male. Melanoma / drug therapy. Melanoma / pathology. Middle Aged. Models, Biological. Sarcoma, Kaposi / drug therapy. Sarcoma, Kaposi / pathology. Time Factors

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  • (PMID = 11479432.001).
  • [ISSN] 0960-8931
  • [Journal-full-title] Melanoma research
  • [ISO-abbreviation] Melanoma Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; Q41OR9510P / Melphalan
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9. Moncrieff MD, Kroon HM, Kam PC, Stalley PD, Scolyer RA, Thompson JF: Isolated limb infusion for advanced soft tissue sarcoma of the extremity. Ann Surg Oncol; 2008 Oct;15(10):2749-56
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  • [Title] Isolated limb infusion for advanced soft tissue sarcoma of the extremity.
  • BACKGROUND: Isolated limb infusion (ILI) is a minimally invasive technique for delivering high-dose regional chemotherapy.
  • We report our experience with ILI for the treatment of soft tissue sarcoma (STS).
  • METHODS: From our prospective database, 21 patients with STS of the limb treated with ILI between 1994 and 2007 were identified.
  • In all patients, a high-dose cytotoxic drug combination was used.
  • Eighteen patients (86%) had lower limb tumors.
  • The procedure was well tolerated.
  • Fourteen patients (67%) received ILI before definitive surgery.
  • CR and malignant fibrous histiocytoma tumor subtype were associated with a lower local recurrence rate.
  • A lower initial skin temperature (median 35.8 degrees C) was associated with a CR (P = .033).
  • Patients who had a steep increase in intramuscular temperature during the procedure were more likely to have a CR (P = .055).
  • Ultimately, the overall limb salvage rate was 76%.
  • CONCLUSION: The outcomes after ILI are comparable to those achieved by conventional isolated limb perfusion.
  • ILI is a minimally invasive alternative to isolated limb perfusion for patients with advanced STS of the extremity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Cancer, Regional Perfusion. Extremities / pathology. Neoplasm Recurrence, Local / drug therapy. Sarcoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Cohort Studies. Dactinomycin / administration & dosage. Female. Humans. Male. Melphalan / administration & dosage. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging. Prognosis. Prospective Studies. Survival Rate

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  • (PMID = 18648882.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 1CC1JFE158 / Dactinomycin; Q41OR9510P / Melphalan
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10. Fraker DL: Management of in-transit melanoma of the extremity with isolated limb perfusion. Curr Treat Options Oncol; 2004 Jun;5(3):173-84
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  • [Title] Management of in-transit melanoma of the extremity with isolated limb perfusion.
  • In-transit metastases for melanoma are a type of stage III regional metastatic disease that are intradermal or subcutaneous nodules growing within lymphatics and not in nodal basins.
  • If the initial diagnosis is a limited number of in-transit metastases (1-3 nodules), the optimal management is simple surgical excision with minimal negative margins and primary closures and appropriate staging to look for any distant metastases.
  • Patients who are diagnosed with additional lesions in a short period of time or patients who at initial diagnosis have large numbers of nodules are candidates for isolated limb perfusion (ILP).
  • Once isolation is obtained surgically, the limb is heated to what is considered mild hyperthermia (38.5 degrees -40 degrees C), then chemotherapeutics are administered at very high concentrations for a 60- to 90-minute treatment.
  • The drug recirculates and, at the end of the treatment period, it is flushed from the extremity and the circulation is re-established.
  • The optimal regimen is melphalan dosed per limb volume (10 mg/L limb volume for lower extremities and 13 mg/L limb volume for upper extremities) with mild hyperthermia for 60 minutes.
  • The major toxicities are skin erythema, myopathy, and peripheral neuropathy.
  • There have been several studies adding high-dose tumor necrosis factor to ILP, but there is no clear benefit in the treatment of melanoma.
  • Other new approaches include isolated limb infusion as a percutaneous procedure to avoid the surgical toxicity.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion. Melanoma / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols. Extremities. Humans. Hyperthermia, Induced. Neoplasm Metastasis. Randomized Controlled Trials as Topic

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  • (PMID = 15115646.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 35
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11. Barbour AP, Thomas J, Suffolk J, Beller E, Smithers BM: Isolated limb infusion for malignant melanoma: predictors of response and outcome. Ann Surg Oncol; 2009 Dec;16(12):3463-72
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  • [Title] Isolated limb infusion for malignant melanoma: predictors of response and outcome.
  • PURPOSE: Isolated limb infusion (ILI) is an alternative to isolated limb perfusion (ILP) for the treatment of unresectable limb melanoma recurrence.
  • The aims of this study were to determine the response rates of unresectable local and/or in-transit melanoma of the upper or lower limb to ILI and to identify factors predictive of survival.
  • Median maximum temperature achieved was 38.1 degrees C and median tourniquet time was 32.5 min.
  • Wieberdink III/IV complications occurred following 7/74 (10%) ILI and were associated with higher limb volumes and higher total melphalan dose.
  • Univariable analyses found that limb volume >8.0 l and maximum limb temperature >38.5 degrees C were the only independent factors predictive for a CR following ILI.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion. Extremities / pathology. Lymph Nodes / pathology. Melanoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Hyperthermia, Induced. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Prognosis. Prospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 19830498.001).
  • [ISSN] 1534-4681
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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12. Guadagni S, Russo F, Rossi CR, Pilati PL, Miotto D, Fiorentini G, Deraco M, Santinami M, Palumbo G, Valenti M, Amicucci G: Deliberate hypoxic pelvic and limb chemoperfusion in the treatment of recurrent melanoma. Am J Surg; 2002 Jan;183(1):28-36
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  • [Title] Deliberate hypoxic pelvic and limb chemoperfusion in the treatment of recurrent melanoma.
  • BACKGROUND: The treatment of patients with advanced or recurrent pelvic melanoma, which are often associated with lesions in the lower limbs, is still unsatisfactory and controversial.
  • A simplified hypoxic pelvic and limb perfusion has been recently recommended to provide therapeutic options for palliation and possibly cure.
  • METHODS: A nonrandomized and noncontrolled phase II experimental study was performed in 11 patients with symptomatic unresectable recurrent melanoma of the pelvis and limb.
  • Patients were submitted to hypoxic pelvic and limb perfusion with 25 mg/m(2) of melphalan, 50 mg/m(2) of cisplatin, 300 mg/m(2) of dacarbazine, and 75 mg/m(2) of epirubicin by means of a simplified balloon occlusion technique.
  • Response rate and time to disease progression were the primary endpoints; overall survival was the secondary endpoint.
  • Median time to disease progression was 12 months (range 9 to 30 months).
  • CONCLUSIONS: Hypoxic pelvic and limb perfusion is a safe and good palliative treatment for patients with unresectable recurrent melanoma.
  • [MeSH-major] Anoxia. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Cancer, Regional Perfusion. Melanoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Dacarbazine / administration & dosage. Disease Progression. Disease-Free Survival. Epirubicin / administration & dosage. Female. Hemodynamics. Humans. Leg / pathology. Male. Melphalan / administration & dosage. Middle Aged. Palliative Care. Pelvis. Treatment Outcome

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  • (PMID = 11869699.001).
  • [ISSN] 0002-9610
  • [Journal-full-title] American journal of surgery
  • [ISO-abbreviation] Am. J. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 3Z8479ZZ5X / Epirubicin; 7GR28W0FJI / Dacarbazine; Q20Q21Q62J / Cisplatin; Q41OR9510P / Melphalan
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13. Bonenkamp JJ, Thompson JF, de Wilt JH, Doubrovsky A, de Faria Lima R, Kam PC: Isolated limb infusion with fotemustine after dacarbazine chemosensitisation for inoperable loco-regional melanoma recurrence. Eur J Surg Oncol; 2004 Dec;30(10):1107-12
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  • [Title] Isolated limb infusion with fotemustine after dacarbazine chemosensitisation for inoperable loco-regional melanoma recurrence.
  • BACKGROUND: Isolated limb infusion (ILI) is a simple yet effective alternative to conventional isolated limb perfusion for the treatment of advanced melanoma of the extremities.
  • PATIENTS AND METHODS: The study group comprised 13 patients with very advanced limb disease who had failed to achieve a satisfactory response to one or more ILIs with melphalan, and in whom amputation was the only other realistic treatment option.
  • Limb salvage was achieved in five of 12 assessable patients (42%).
  • Limb toxicity peaked 9 days after ILI; two patients experienced Wieberdink grade IV (severe) toxicity and four patients had grade V toxicity (requiring early amputation).
  • CONCLUSIONS: ILI with fotemustine after DTIC chemosensitisation can be successful when gross limb disease has not been controlled by one or more ILIs with melphalan.
  • However, it cannot be recommended as a routine method of treatment for advanced melanoma of the extremities because of the high incidence of severe limb toxicity.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Antineoplastic Agents, Alkylating / therapeutic use. Chemotherapy, Cancer, Regional Perfusion. Dacarbazine / therapeutic use. Lower Extremity. Melanoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Nitrosourea Compounds / therapeutic use. Organophosphorus Compounds / therapeutic use. Skin Neoplasms / drug therapy
  • [MeSH-minor] Aged. Aged, 80 and over. Amputation. Follow-Up Studies. Humans. Limb Salvage. Middle Aged. Neoplasm Staging. Remission Induction. Salvage Therapy. Treatment Outcome

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  • (PMID = 15522559.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Alkylating; 0 / Nitrosourea Compounds; 0 / Organophosphorus Compounds; 7GR28W0FJI / Dacarbazine; GQ7JL9P5I2 / fotemustine
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14. Lejeune FJ, Pujol N, Liénard D, Mosimann F, Raffoul W, Genton A, Guillou L, Landry M, Chassot PG, Chiolero R, Bischof-Delaloye A, Leyvraz S, Mirimanoff RO, Bejkos D, Leyvraz PF: Limb salvage by neoadjuvant isolated perfusion with TNFalpha and melphalan for non-resectable soft tissue sarcoma of the extremities. Eur J Surg Oncol; 2000 Nov;26(7):669-78
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  • [Title] Limb salvage by neoadjuvant isolated perfusion with TNFalpha and melphalan for non-resectable soft tissue sarcoma of the extremities.
  • AIMS: Patients with non-resectable soft tissue sarcomas of the extremities do not live longer if they are treated by amputation or disarticulation.
  • In order to avoid major amputations, we tested isolated limb perfusion (ILP) with tumour necrosis factor alpha (TNF)+melphalan+/-interferon-gamma (IFN) as a pre-operative, neoadjuvant limb salvage treatment.
  • METHODS: Twenty-two patients were included (six men and 16 women; three upper limb and 19 lower limb tumours).
  • Thirteen cases were recurrent or progressive after previous therapy; five tumours had a diameter >/=20 cm, and four were multiple or regionally metastatic.
  • All patients had fever for 24 hours but only one developed a reversible grade 3 distributive shock syndrome with no sequelae.
  • Seventeen patients (77%) underwent limb-sparing resection of the tumour remnants after a median time of 3.4 months: 10 resections were intracompartmental and seven extracompartmental.
  • Surgery included flaps or skin grafts in five patients, arterial replacement in two and knee arthrodesis in one.
  • Adjuvant chemotherapy was given to eight patients and radiotherapy to six.
  • Secondary amputations were performed for recurrence in two patients, resulting in an overall limb salvage rate of 19/22 (86%).
  • The median disease free and overall survival times have been >12.5 and 18.7 months respectively: this is similar to the outcome after primary amputations for similar cases.
  • CONCLUSION: ILP with TNF and chemotherapy is an efficient limb sparing neoadjuvant therapy for a priori non-resectable limb soft tissue sarcomas.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Leg / surgery. Sarcoma / drug therapy. Sarcoma / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Chemotherapy, Cancer, Regional Perfusion. Disease-Free Survival. Doxorubicin / administration & dosage. Female. Humans. Ifosfamide / administration & dosage. Interferon-gamma / administration & dosage. Interferon-gamma / adverse effects. Male. Melphalan / administration & dosage. Melphalan / adverse effects. Middle Aged. Neoadjuvant Therapy. Neoplasm Recurrence, Local / surgery. Radiotherapy, Adjuvant. Salvage Therapy. Survival Analysis. Tumor Necrosis Factor-alpha / administration & dosage. Tumor Necrosis Factor-alpha / adverse effects

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 11078614.001).
  • [ISSN] 0748-7983
  • [Journal-full-title] European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • [ISO-abbreviation] Eur J Surg Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] ENGLAND
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha; 80168379AG / Doxorubicin; 82115-62-6 / Interferon-gamma; Q41OR9510P / Melphalan; UM20QQM95Y / Ifosfamide
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15. Germain MA, Bonvalot S, Rimareix F, Missana CM: [Locally advanced soft-tissue sarcomas. An innovating triad to avoid amputation: isolated limb perfusion, TNFalpha, and free microsurgical flap]. Bull Acad Natl Med; 2010 Jan;194(1):51-65; discussion 65-7
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  • [Title] [Locally advanced soft-tissue sarcomas. An innovating triad to avoid amputation: isolated limb perfusion, TNFalpha, and free microsurgical flap].
  • [Transliterated title] Sauvetage des membres atteints de sarcome localement evolué. La triade innovante: perfusion de membre isole sous CEC, TNFalpha, et transplant microchirurgical.
  • We retrospectively studied the benefits of isolated limb perfusion combined with TNFalpha administration and free flap reconstruction in locally advanced soft-tissue sarcomas of the limbs.
  • Between 2000 and 2008, we treated 37 patients (22 women and 15 men) with locally advanced soft tissue sarcomas.
  • The sarcomas were located in the lower and upper limbs in respectively 26 and 11 cases, and had a mean diameter of 15 cm and 12 cm, respectively.
  • Seventeen patients received neoadjuvant chemotherapy.
  • Sarcoma excision was combined with a complementary procedure in 10 patients (vascular graft or nerve anastomosis).
  • Three major improvements were made in recent years, namely isolated limb perfusion, TNFalpha administration, and free flap reconstruction two months after resection of residual sarcoma.
  • The procedure lasted a median of 7 hours.
  • The limb was preserved in 78% of cases.
  • Thirteen patients developed pulmonary metastases and seven of them died between the first and fifth years of follow-up.
  • Isolated limb perfusion and free flap reconstruction permitted more extensive tumor excision.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chemotherapy, Cancer, Regional Perfusion. Extremities / surgery. Sarcoma / drug therapy. Sarcoma / surgery. Soft Tissue Neoplasms / drug therapy. Soft Tissue Neoplasms / surgery. Tumor Necrosis Factor-alpha / therapeutic use
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Lung Neoplasms / mortality. Lung Neoplasms / secondary. Male. Middle Aged. Muscle, Skeletal / transplantation. Neoadjuvant Therapy. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / surgery. Neoplasms, Radiation-Induced / drug therapy. Neoplasms, Radiation-Induced / surgery. Neoplasms, Second Primary / drug therapy. Neoplasms, Second Primary / surgery. Radiotherapy, Adjuvant. Reconstructive Surgical Procedures. Reoperation. Retrospective Studies. Skin Transplantation. Surgical Flaps. Treatment Outcome. Young Adult

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  • (PMID = 20669559.001).
  • [ISSN] 0001-4079
  • [Journal-full-title] Bulletin de l'Académie nationale de médecine
  • [ISO-abbreviation] Bull. Acad. Natl. Med.
  • [Language] fre
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha
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16. Lindnér P, Doubrovsky A, Kam PC, Thompson JF: Prognostic factors after isolated limb infusion with cytotoxic agents for melanoma. Ann Surg Oncol; 2002 Mar;9(2):127-36
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  • [Title] Prognostic factors after isolated limb infusion with cytotoxic agents for melanoma.
  • BACKGROUND: Isolated limb perfusion (ILP) with cytotoxic agents is a remarkably effective but complex technique used to treat locally recurrent and metastatic melanoma confined to a limb.
  • Isolated limb infusion (ILI), essentially a low-flow ILP performed without oxygenation via percutaneous catheters, has been developed as a simpler alternative.
  • RESULTS: The overall response rate in the treated limb was 85% (complete response [CR] rate 41%, partial response rate 44%).
  • CR rate and survival time decreased with increasing disease stage.
  • On multivariate analysis, factors associated with an improved outcome were a lower stage of disease, a final limb temperature >37.8 degrees C, and a tourniquet time >40 minutes.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Chemotherapy, Cancer, Regional Perfusion / methods. Extremities. Melanoma / drug therapy. Melanoma / secondary. Melphalan / administration & dosage. Neoplasm Recurrence, Local / drug therapy. Skin Neoplasms / drug therapy

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  • (PMID = 11888868.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; Q41OR9510P / Melphalan
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17. Guadagni S, Santinami M, Patuzzo R, Pilati PL, Miotto D, Deraco M, Rossi CR, Fiorentini G, Di Filippo F, Valenti M, Amicucci G: Hypoxic pelvic and limb perfusion with melphalan and mitomycin C for recurrent limb melanoma: a pilot study. Melanoma Res; 2003 Feb;13(1):51-8
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  • [Title] Hypoxic pelvic and limb perfusion with melphalan and mitomycin C for recurrent limb melanoma: a pilot study.
  • Hypoxic pelvic and limb perfusion by means of a balloon occlusion technique was evaluated in patients with recurrent melanoma of the lower limbs who were non-responders to isolated hyperthermic limb perfusion or who were not eligible for this procedure.
  • A pilot study was performed in 17 patients, who underwent hypoxic pelvic and limb perfusion with 50 mg/m(2) of melphalan or 50 mg/m(2) of melphalan and 25 mg/m(2) of mitomycin C.
  • Each procedure was followed by haemofiltration.
  • The response rate and time to disease progression were the primary endpoints, with overall survival as the secondary endpoint.
  • After one course of treatment, the objective response rate was 47% (95% confidence interval 22.5-71.5%), the median time to disease progression was 10 months (range 2-40 months), and the 3 year overall survival was 20%.
  • Hypoxic pelvic and limb perfusion seems to be a safe and effective treatment for patients with unresectable recurrent limb melanoma who are not eligible for isolated hyperthermic limb perfusion.
  • Further studies are necessary to establish whether the response rates can be improved by using different drug regimens.
  • [MeSH-major] Anoxia. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Chemotherapy, Cancer, Regional Perfusion. Melanoma / drug therapy. Neoplasm Recurrence, Local / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Disease Progression. Extremities / pathology. Female. Humans. Male. Maximum Tolerated Dose. Melphalan / administration & dosage. Middle Aged. Mitomycin / administration & dosage. Pilot Projects. Survival Rate. Time Factors

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  • (PMID = 12569285.001).
  • [ISSN] 0960-8931
  • [Journal-full-title] Melanoma research
  • [ISO-abbreviation] Melanoma Res.
  • [Language] eng
  • [Publication-type] Clinical Trial; Controlled Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 50SG953SK6 / Mitomycin; Q41OR9510P / Melphalan
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18. Rossi CR, Foletto M, Mocellin S, Pilati PL, Campana L, Rubello D, Lise M: TNF-based limb perfusion for cutaneous melanoma in transit metastases: suggestions for modification of the perfusional schedule. J Exp Clin Cancer Res; 2003 Dec;22(4 Suppl):103-7
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  • [Title] TNF-based limb perfusion for cutaneous melanoma in transit metastases: suggestions for modification of the perfusional schedule.
  • Isolated limb perfusion (ILP) is currently considered the standard treatment for melanoma patients with extensive in-transit disease, and L-PAM, combined or not with TNF, represents the most active drug.
  • We here report on our clinical experience with TNF-based limb perfusion.
  • Thirty-seven stage III patients underwent TNF-based limb perfusion, 22 with bulky disease, 15 with recurrences after perfusion with L-PAM.
  • Our results showed that it is possible to modify the perfusion schedule, without compromising the response rate but with lower cost and toxicity.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion. Melanoma / drug therapy. Skin Neoplasms / drug therapy. Tumor Necrosis Factor-alpha / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents, Alkylating / therapeutic use. Dose-Response Relationship, Drug. Extremities / pathology. Female. Humans. Hyperthermia, Induced. Male. Melphalan / therapeutic use. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Time Factors. Treatment Outcome

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  • [ErratumIn] J Exp Clin Cancer Res. 2006 Sep;25(3):preceding table of contents. Ribello, D [corrected to Rubello, D]
  • (PMID = 16767915.001).
  • [ISSN] 0392-9078
  • [Journal-full-title] Journal of experimental & clinical cancer research : CR
  • [ISO-abbreviation] J. Exp. Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Multicenter Study
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
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19. Kroon HM, Lin DY, Kam PC, Thompson JF: Safety and efficacy of isolated limb infusion with cytotoxic drugs in elderly patients with advanced locoregional melanoma. Ann Surg; 2009 Jun;249(6):1008-13
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  • [Title] Safety and efficacy of isolated limb infusion with cytotoxic drugs in elderly patients with advanced locoregional melanoma.
  • INTRODUCTION: The treatment of elderly patients with advanced metastatic melanoma confined to a limb remains controversial.
  • Isolated limb infusion (ILI) is an effective minimally invasive alternative to isolated limb perfusion (ILP) and is therefore a potentially valuable therapeutic option for this group.
  • METHODS: From our prospective database 185 patients with advanced metastatic melanoma of the limb treated with a single ILI between 1992 and 2007 were identified.
  • The patient characteristics in both groups were comparable except that the older group comprised more women (71% vs. 54%; P = 0.02) and had a lower body mass index (median: 24.4 vs. 26.4; P = 0.008).
  • There was no difference in limb recurrence free interval after a complete response (median: 24 months for both groups; P = 0.51) or in survival (median: 36 months for <75, 39 months for >or=75; P = 0.36) between both groups.
  • Older patients experienced less limb toxicity after the procedure (Wieberdink grade III/IV toxicity in 36%) compared with younger patients (51%; P = 0.009) while systemic toxicity, complications, and long-term morbidity were similar.
  • CONCLUSIONS: Elderly patients with advanced metastatic melanoma of the limb experience the same or lower toxicity after ILI compared with younger patients while response rates, limb recurrence free interval, survival, and morbidity are similar.
  • [MeSH-major] Chemotherapy, Cancer, Regional Perfusion / methods. Melanoma / drug therapy. Melanoma / pathology. Skin Neoplasms / drug therapy. Skin Neoplasms / pathology
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Arm. Cohort Studies. Female. Humans. Hyperthermia, Induced. Infusions, Intra-Arterial. Leg. Male. Middle Aged. Neoplasm Invasiveness. Retrospective Studies. Treatment Outcome

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  • (PMID = 19474677.001).
  • [ISSN] 1528-1140
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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20. Zogakis TG, Bartlett DL, Libutti SK, Liewehr DJ, Steinberg SM, Fraker DL, Alexander HR: Factors affecting survival after complete response to isolated limb perfusion in patients with in-transit melanoma. Ann Surg Oncol; 2001 Dec;8(10):771-8
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  • [Title] Factors affecting survival after complete response to isolated limb perfusion in patients with in-transit melanoma.
  • BACKGROUND: Isolated limb perfusion (ILP) results in complete response (CR) rates of 60% to 90% in patients with regionally advanced melanoma.
  • Survival after a CR may be influenced by various factors, particularly out-of-field disease in iliac lymph nodes (ILN) identified during lower-extremity ILP.
  • METHODS: From May 1992 to July 1997, 50 patients (16 men and 34 women; median age, 57 years) with stage IIIA or IIIAB melanoma had a CR to a 90-minute hyperthermic iliac ILP with melphalan (10 mg/L limb volume, n = 20) or melphalan and tumor necrosis factor (4-6 mg+/-200 microg interferon; n = 30).
  • By univariate analysis, there was a trend for improved outcome with female sex and stage IIIA (vs. IIIAB) at initial diagnosis was associated with improved survival after a CR to ILP (P = .056 and .012, respectively).
  • The probability of overall in-field recurrence was 70% after 4 years, and there was no difference between those with or without positive ILNs; median time to in-field recurrence was 13 and 19 months, respectively (P = .62).
  • Of note, Cox models identified that the risk of death was significantly greater in those with a history of prior systemic therapy (hazard ratio: 2.67 [95% confidence interval, 1.17-6.11]; P = .02) and those with an in-transit lesion size > or =1.4 cm2 (hazard ratio, 3.12 [95% confidence interval, 1.30-7.5]; P = .011).
  • In addition, patients who have a CR after ILP and have a history of prior treatment or larger lesions should be considered for adjuvant systemic therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Melanoma / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Cancer, Regional Perfusion / methods. Disease-Free Survival. Extremities / blood supply. Female. Humans. Hyperthermia, Induced / methods. Interferons / administration & dosage. Lymphatic Metastasis. Male. Melphalan / administration & dosage. Middle Aged. Neoplasm Staging. Tumor Necrosis Factor-alpha / administration & dosage

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  • (PMID = 11776490.001).
  • [ISSN] 1068-9265
  • [Journal-full-title] Annals of surgical oncology
  • [ISO-abbreviation] Ann. Surg. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Tumor Necrosis Factor-alpha; 9008-11-1 / Interferons; Q41OR9510P / Melphalan
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21. Poulsen M, Rischin D, Walpole E, Harvey J, Mackintosh J, Ainslie J, Hamilton C, Keller J, Tripcony L, Trans-Tasman Radiation Oncology Group: High-risk Merkel cell carcinoma of the skin treated with synchronous carboplatin/etoposide and radiation: a Trans-Tasman Radiation Oncology Group Study--TROG 96:07. J Clin Oncol; 2003 Dec 1;21(23):4371-6
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  • [Title] High-risk Merkel cell carcinoma of the skin treated with synchronous carboplatin/etoposide and radiation: a Trans-Tasman Radiation Oncology Group Study--TROG 96:07.
  • PURPOSE: The effectiveness of synchronous carboplatin, etoposide, and radiation therapy was prospectively assessed in a group of patients with high-risk Merkel cell carcinoma (MCC) of the skin.
  • PATIENTS AND METHODS: Patients were eligible if they had disease localized to the primary site and nodes, and were required to have at least one of the following high risk features: recurrence after initial therapy, involved nodes, primary tumor size greater than 1 cm, gross residual disease after surgery, or occult primary with nodes.
  • Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks and synchronous carboplatin (area under the curve, 4.5) and intravenous etoposide 80 mg/m2 days 1 to 3 was given in weeks 1, 4, 7, and 10.
  • The sites involved were head and neck (22 patients), occult primary (13 patients), upper limb (eight patients), lower limb (eight patients), and trunk (two patients).
  • There were no treatment related deaths.
  • CONCLUSION: High levels of locoregional control and survival have been achieved with the addition of chemotherapy to radiation treatment for high-risk MCC of the skin.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Merkel Cell / drug therapy. Carcinoma, Merkel Cell / radiotherapy. Skin Neoplasms / drug therapy. Skin Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Carboplatin / administration & dosage. Combined Modality Therapy. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / radiotherapy. Prospective Studies. Radiation Oncology. Risk Factors. Societies, Medical. Survival Rate

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  • (PMID = 14645427.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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22. Ford HE, Yap YS, Miles DW, Makris A, Hall M, Miller L, Harries M, Smith IE, Johnston SR: A phase II study of weekly docetaxel in patients with anthracycline pretreated metastatic breast cancer. Cancer Chemother Pharmacol; 2006 Dec;58(6):809-15
Hazardous Substances Data Bank. DOCETAXEL .

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  • Treatment consisted of docetaxel 35 mg/m2 weekly as a 30-min infusion for 6 weeks followed by a 2-week rest, with dexamethasone 8 mg i.v. pre-medication and 4 mg orally 12-hourly for 48 h following treatment.
  • Twenty-six (62%) patients had received prior chemotherapy for advanced disease.
  • Patients received a median 10 weeks of treatment (range 1-24).
  • 11 had a partial response (ORR 26%; 95% CI 13-39%), five of whom had relapsed <12 months since the end of previous anthracycline-based chemotherapy.
  • Skin toxicity consisted of limb/palmar-plantar erythematous reactions, or fixed-plaque erythrodysaesthesia.
  • Although the level of myelosuppression is lower than 3-weekly regimens, this weekly regimen cannot be recommended due to the significant non-haematological toxicities associated with the treatment.
  • [MeSH-major] Anthracyclines / therapeutic use. Breast Neoplasms / drug therapy. Taxoids / therapeutic use
  • [MeSH-minor] Adult. Aged. Alopecia / chemically induced. Antineoplastic Agents, Phytogenic / administration & dosage. Antineoplastic Agents, Phytogenic / adverse effects. Antineoplastic Agents, Phytogenic / therapeutic use. Diarrhea / chemically induced. Drug Administration Schedule. Female. Humans. Middle Aged. Neoplasm Metastasis. Neutropenia / chemically induced. Survival Analysis. Thrombocytopenia / chemically induced. Treatment Outcome

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  • (PMID = 16528527.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Anthracyclines; 0 / Antineoplastic Agents, Phytogenic; 0 / Taxoids; 15H5577CQD / docetaxel
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23. Zhao J, Han B, Shen T, Zhao Y, Wang T, Liu Y, Fang K, Zhong D, Ling Q: Primary cutaneous diffuse large B-cell lymphoma (leg type) after renal allograft: case report and review of the literature. Int J Hematol; 2009 Jan;89(1):113-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary cutaneous diffuse large B-cell lymphoma (leg type) after renal allograft: case report and review of the literature.
  • We report a case of a 58-year-old man who presented with a rapidly growing proliferative lesion on the left lower limb, clinically resembling a soft tissue sarcoma 3 years after renal allograft.
  • There was no evidence of systemic involvement on bone marrow needle aspiration and computed tomography (CT) scans of the chest and abdomen.
  • The lesion turned out to be primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL LT), as defined in the recent World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification of cutaneous lymphomas by skin biopsy.
  • Immunosuppression reduction, chemotherapy with CHOP regimen and local radiotherapy induced complete remission of the tumor.
  • [MeSH-minor] Humans. Leg / pathology. Male. Middle Aged. Neoplasm Invasiveness. Remission Induction / methods. Skin Neoplasms / etiology. Skin Neoplasms / pathology

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  • (PMID = 19109733.001).
  • [ISSN] 1865-3774
  • [Journal-full-title] International journal of hematology
  • [ISO-abbreviation] Int. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 21
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24. Hoekstra HJ: The European approach to in-transit melanoma lesions. Int J Hyperthermia; 2008 May;24(3):227-37
Hazardous Substances Data Bank. MELPHALAN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Three to five per cent of melanoma patients will develop in-transit lesions and the median time to recurrence ranges between 13-16 months.
  • At the time of recurrence the risk of occult nodal metastasis, with clinically negative regional lymph nodes, is as high as 50%.
  • The high incidence of in-transit lesions at the lower limb may be caused by the gravity and delayed lymphatic drainage.
  • The treatment of limited disease is local excision, laser ablation, cryosurgery, while multiple in-transit lesions or bulky disease located in a limb can be successfully treated with regional chemotherapy, a therapeutic isolated limb perfusion or infusion with melphalan or a combination of melphalan and tumor necrosis factor (TNF) alpha.
  • If local regional treatment or systemic dacarbazine based systemic treatment fails, novel systemic treatment strategies with vaccines, antibodies and gene therapy are currently investigated.
  • [MeSH-major] Hyperthermia, Induced / methods. Melanoma / drug therapy. Neoplasm Recurrence, Local / prevention & control. Skin Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Combined Modality Therapy / methods. Europe. Humans. Lymph Nodes / drug effects. Lymphatic Metastasis / prevention & control. Melphalan / therapeutic use. Tumor Necrosis Factor-alpha / therapeutic use

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  • (PMID = 18393001.001).
  • [ISSN] 0265-6736
  • [Journal-full-title] International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
  • [ISO-abbreviation] Int J Hyperthermia
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Tumor Necrosis Factor-alpha; Q41OR9510P / Melphalan
  • [Number-of-references] 58
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25. Hornick JL, Jaffe ES, Fletcher CD: Extranodal histiocytic sarcoma: clinicopathologic analysis of 14 cases of a rare epithelioid malignancy. Am J Surg Pathol; 2004 Sep;28(9):1133-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Histiocytic sarcoma is a rare malignant neoplasm that occurs in lymph nodes, skin, and the gastrointestinal tract.
  • Seven tumors arose in soft tissue (6 lower limb; 1 upper limb), 5 in the gastrointestinal tract (1 involving both stomach and colon, 1 ileum, 2 rectum, 1 anus), 1 in the nasal cavity, and 1 in the lung.
  • Six patients were treated with postoperative radiation and 7 with chemotherapy (CHOP or ProMACE-MOPP).
  • Two tumors recurred locally, and 5 patients developed distant spread: 3 to lymph nodes, 1 to lung, and 1 to bone.
  • At the last follow-up, 2 patients have died of disseminated disease, 4 and 5 months following initial diagnosis.
  • Histiocytic sarcoma may arise primarily in soft tissue and shows reproducible histologic features, including abundant eosinophilic cytoplasm and a prominent inflammatory infiltrate.

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  • (PMID = 15316312.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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26. Abe T, Kamida T, Goda M, Inoue R, Fujiki M, Kobayashi H, Hatano Y, Shibuya H, Fujiwara S, Terashi H, Mori T: Intracranial infiltration by recurrent scalp dermatofibrosarcoma protuberans. J Clin Neurosci; 2009 Oct;16(10):1358-60
MedlinePlus Health Information. consumer health - Skin Cancer.

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  • Dermatofibrosarcoma protuberans (DFSP) of the scalp is a rare soft tissue sarcoma.
  • A 22-year-old male with DFSP, who had undergone several surgical excisions and radiotherapy, presented with a mild left lower-limb paresis.
  • Despite this, there were several recurrences; thereafter, the patient underwent surgery, stereotactic radiosurgery and chemotherapy.
  • [MeSH-major] Dermatofibrosarcoma / surgery. Neoplasm Recurrence, Local / surgery. Scalp / pathology. Skin Neoplasms / surgery

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  • (PMID = 19560926.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Scotland
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27. Eggermont AM, Gore M: European approach to adjuvant treatment of intermediate- and high-risk malignant melanoma. Semin Oncol; 2002 Aug;29(4):382-8
MedlinePlus Health Information. consumer health - Skin Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] European approach to adjuvant treatment of intermediate- and high-risk malignant melanoma.
  • Adjuvant therapies for patients with melanoma at high risk of relapse whether local, such as excision margins, elective regional lymph node dissection (ELND), and prophylactic isolated limb perfusion (ILP), or systemic, such as chemotherapy, immunotherapy, immunochemotherapy, or vaccination therapy, have little or no impact on survival when evaluated in randomized trials.
  • The European approach to the treatment of each stage of malignant melanoma is characterized by thoughtful caution with particular attention being paid to the avoidance of unwarranted mutilation or toxicity because phase 3 studies have failed to demonstrate unequivocal benefits for a more aggressive approach.
  • In Europe, there is no standard adjuvant systemic therapy; high-dose interferon (IFN) is used sporadically in individual patients by some physicians, but there is little enthusiasm for adopting this regimen as the standard of care because of its high toxicity profile and the lack of a clear beneficial impact on long-term survival.
  • Less toxic lower-dose maintenance IFN regimens, antiangiogenic agents, and vaccine therapies are currently being explored.
  • [MeSH-major] Melanoma / surgery. Neoadjuvant Therapy. Skin Neoplasms / surgery
  • [MeSH-minor] Angiogenesis Inhibitors / therapeutic use. Antineoplastic Agents / administration & dosage. Antineoplastic Agents / therapeutic use. Cancer Vaccines / therapeutic use. Chemotherapy, Adjuvant. Chemotherapy, Cancer, Regional Perfusion. Elective Surgical Procedures. Europe. Humans. Immunotherapy. Interferon-alpha / administration & dosage. Interferon-alpha / therapeutic use. Lymph Node Excision. Neoplasm Recurrence, Local / pathology. Randomized Controlled Trials as Topic. Risk Factors. Survival Rate. Vaccination

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  • [Copyright] Copyright 2002, Elsevier Science (USA). All rights reserved.
  • (PMID = 12170441.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents; 0 / Cancer Vaccines; 0 / Interferon-alpha
  • [Number-of-references] 52
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28. Eggermont AM: European approach to the treatment of malignant melanoma. Curr Opin Oncol; 2002 Mar;14(2):205-11
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  • [Title] European approach to the treatment of malignant melanoma.
  • The European approach to the treatment of each stage of malignant melanoma can be characterized as cautious, avoiding unwarranted mutilation or toxicity, because phase III trials have demonstrated that an aggressive approach in surgical management, adjuvant therapy, and treatment of stage IV disease has met with little success.
  • Phase III trials have demonstrated that wide margins, elective lymph node dissections, and prophylactic isolated limb perfusions bring no survival benefit.
  • There is no standard adjuvant therapy.
  • High-dose interferon treatment is practiced only sporadically in Europe because its high toxicity profile and an unclear long-term impact on survival are not popular.
  • Long-term nontoxic lower-dose interferon regimens and vaccines are currently being explored.
  • Phase III trials have shown that highly toxic polychemotherapy or biochemotherapy has not produced a survival benefit over simple treatment with dacarbazide alone.
  • [MeSH-major] Melanoma / drug therapy. Skin Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Europe. Humans. Neoplasm Staging

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  • (PMID = 11880712.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 62
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29. Brambilla L, Bellinvia M, Tourlaki A, Scoppio B, Gaiani F, Boneschi V: Intralesional vincristine as first-line therapy for nodular lesions in classic Kaposi sarcoma: a prospective study in 151 patients. Br J Dermatol; 2010 Apr;162(4):854-9
Hazardous Substances Data Bank. VINCRISTINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intralesional vincristine as first-line therapy for nodular lesions in classic Kaposi sarcoma: a prospective study in 151 patients.
  • BACKGROUND: Classic Kaposi sarcoma is a rare angioproliferative neoplasm with varying biological behaviour.
  • Depending on the clinical stage, local or systemic therapy can be used.
  • Vincristine has proven to be effective as systemic chemotherapy and in very few reports as intralesional treatment.
  • OBJECTIVES: Our aim was to determine the efficacy and safety of intralesional vincristine in the treatment of classic Kaposi sarcoma nodular lesions.
  • Vincristine was injected in a single nodule (0.3-0.8 mm) on the lower limb.
  • Another similar lesion on the same limb, at a distance of >or= 10 cm, or on the contralateral limb, was kept under clinical observation as control.
  • Therapy was generally well tolerated.
  • CONCLUSIONS: Intralesional vincristine is an effective and safe treatment for nodular lesions in classic Kaposi sarcoma and can be recommended as first-line therapy in initial stages and as support therapy in advanced stages.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Sarcoma, Kaposi / drug therapy. Skin Neoplasms / drug therapy. Vincristine / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Drug Administration Schedule. Female. Humans. Injections, Intralesional. Male. Middle Aged. Prospective Studies. Treatment Outcome

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  • [ErratumIn] Br J Dermatol. 2010 Apr;162(4):907-8. Dosage error in article text
  • (PMID = 19995366.001).
  • [ISSN] 1365-2133
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 5J49Q6B70F / Vincristine
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30. Bula P, Bula-Sternberg J, Wollina U, Haroske G, Bonnaire F: [Marjolin's ulcer: malignant transformation of a crural ulcer due to posttraumatic chronic osteomyelitis]. Unfallchirurg; 2010 Feb;113(2):149-54
MedlinePlus Health Information. consumer health - Leg Injuries and Disorders.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We report on the case of an 81-year-old female patient who developed a squamous cell carcinoma in a long-lasting therapy-resistant crural ulcer of the lower leg due to posttraumatic chronic osteomyelitis.
  • Eventually the lower leg had to be amputated because of massive destruction of soft tissue and the tibia bone.
  • Based on the desolate wound conditions plastic reconstruction by a pivoted muscle flap and surgical covering with mesh graft plastic was also necessary.The amputation stump had completely healed 6 months after surgery and the patient is fitted with an artificial limb ensuring independent mobility even outside the home.
  • [MeSH-major] Amputation. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Cell Transformation, Neoplastic / pathology. Leg Injuries / pathology. Leg Injuries / surgery. Leg Ulcer / pathology. Leg Ulcer / surgery. Osteomyelitis / pathology. Osteomyelitis / surgery. Pseudomonas Infections / pathology. Pseudomonas Infections / surgery. Pseudomonas aeruginosa. Skin Ulcer / pathology. Tibia / surgery. Wounds, Penetrating / pathology. Wounds, Penetrating / surgery
  • [MeSH-minor] Aged, 80 and over. Artificial Limbs. Chronic Disease. Disease Progression. Drug Resistance, Bacterial. Female. Humans. Magnetic Resonance Imaging. Neoplasm Staging. Skin / pathology

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  • (PMID = 19859679.001).
  • [ISSN] 1433-044X
  • [Journal-full-title] Der Unfallchirurg
  • [ISO-abbreviation] Unfallchirurg
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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