The use of isolated limb perfusion to manage recurrent malignant melanoma.

Hyperthermic isolated limb perfusion (ILP) effectively treats locally recurrent metastatic disease in malignant melanoma of the extremities. The goal of ILP is to decrease the rate of further recurrent disease and eradicate tumor load to achieve wound hygiene and preservation of limb function. This article reviews the development over the last 45 years of ILP in the treatment of malignant melanoma, describes the surgical technique of ILP, and reviews the results of clinical trials with various chemotherapeutic agents. It discusses the recent addition of tumor necrosis factor alpha to the list of drugs currently being explored in hyperthermic ILP, in the ongoing attempt to improve the treatment for recurrent malignant melanoma of the extremities.