Isolated Limb Infusion

Virginia Mason, in Seattle, is one of only a handful of cancer centers to offer isolated limb infusion (ILI) for the treatment of metastatic melanoma, the most dangerous and deadly form of skin cancer.

First introduced in the mid-1950s as isolated limb perfusion and then later made less complex using minimally invasive techniques by surgeons in Sydney, Australia in the 1990s, the isolated limb infusion procedure is rare and highly specialized due to the surgical skill requirements of complex vascular surgery and interventional radiology.

Why use isolated limb infusion?

Isolated limb infusion is used for a type of metastatic melanoma called in-transit metastases. This form of melanoma spreads along lymphatic vessels in the skin and forms nodules either in the skin or under the skin away from the primary melanoma site. Surgical removal is difficult because there are too many nodules to remove and they will almost always recur. ILI can be used to deliver high dose chemotherapy drugs directly to the cancer site on an arm or leg.

What happens during isolated limb infusion?

The flow of blood to and from the limb is temporarily stopped with a tourniquet, and the drugs are put directly into the blood of the limb for up to 40 minutes. Isolating the limb prevents high doses of chemotherapy drugs from affecting other organs. The procedure is performed in the operating room with the patient under general anesthesia. At the end of the procedure, the drugs are flushed out of the limb and circulation is returned to normal. The entire procedure takes about three hours.

Isolated Limb Infusion Treatment Results

Several thousand cases of this specialized procedure have been done in the United States and Europe over the past 30 years. More than 80 percent of patients who receive the treatment have a good response where their melanoma tumor nodules shrink significantly or disappear. If necessary, the procedure can be administered more than once.