Traitement des récidives locales et en transit des mélanomes par perfusion de membre isolé: Intérêt de l'échographie-Doppler

Purpose. To assess the effectiveness of Color Doppler Ultrasound (US) in the follow-up of recurrent melanoma of the limbs treated by isolated limb perfusion (ILP). Materials and methods. A retrospective study was done looking at 18 patients treated by isolated perfusion of the limb. Number, size and vascularity of subcutaneous metastases were examine for all patients. The results of pre and post therapeutic examinations were compared with clinical data and evolution. Results. US was superior to clinical examination in the detection and measurement of subcutaneous metastases. Decrease in tumor size and early disappearance of tumoral vascularity were associated with an effective tumor response to treatment. Early disappearance of vascularity was associated with early complete response. Initial presence or persistence of vascularity before the third month after treatment were not poor prognostic factors. The appearance of vascularity seemed to be an indicator of early failure of the treatment. Conclusion. Color Doppler US is highly effective for the follow-up of patients with recurrent melanoma of the limbs. It provides prognostic factors of treatment failure, which may lead to early modification of the treatment strategy.