OBJECTIVE: The aim of this study is to describe the experience with 100 TNF-based ILP for locally advanced melanoma and to determine prognostic factors for response, time to local progression, and survival. METHODS: One hundred TNF-based ILPs were performed between 1991 and 2003 in 87 patients for whom local control by surgery of in-transit melanoma metastases was impossible. In total, 62 iliac, 33 femoral, and 5 axillary ILPs were performed in mild hyperthermic conditions with 2 to 4 mg of TNF and 10 to 13 mg of melphalan per liter of limb volume. RESULTS: Overall response was 95%, with 69% complete response, 26% partial response, and 5% no change. Complete response rate differed significantly for patients with IIIA disease versus IIIAB and IV. Local and systemic toxicity was mild to moderate in almost all cases, with no treatment-related death and one treatment-related amputation. Five-year overall survival was 32%; local progression occurred in 55% after a median of 16 months. In complete response patients, 5-year survival was 42% with local progression in 52% at a median of 22 months. Response rate and survival were significantly influenced by stage of disease; (local progression free) survival was influenced by response rate. CONCLUSIONS: TNF-based ILP results in excellent response rates in this patient population with unfavorable characteristics. Response on ILP predicts outcome in patients and reflects aggressiveness of the tumor.
OBJECTIVE: The aim of this study is to describe the experience with 100 TNF-based ILP for locally advanced melanoma and to determine prognostic factors for response, time to local progression, and survival. METHODS: One hundred TNF-based ILPs were performed between 1991 and 2003 in 87 patients for whom local control by surgery of in-transit melanoma metastases was impossible. In total, 62 iliac, 33 femoral, and 5 axillary ILPs were performed in mild hyperthermic conditions with 2 to 4 mg of TNF and 10 to 13 mg of melphalan per liter of limb volume. RESULTS: Overall response was 95%, with 69% complete response, 26% partial response, and 5% no change. Complete response rate differed significantly for patients with IIIA disease versus IIIAB and IV. Local and systemic toxicity was mild to moderate in almost all cases, with no treatment-related death and one treatment-related amputation. Five-year overall survival was 32%; local progression occurred in 55% after a median of 16 months. In complete response patients, 5-year survival was 42% with local progression in 52% at a median of 22 months. Response rate and survival were significantly influenced by stage of disease; (local progression free) survival was influenced by response rate. CONCLUSIONS:TNF-based ILP results in excellent response rates in this patient population with unfavorable characteristics. Response on ILP predicts outcome in patients and reflects aggressiveness of the tumor.
Authors: F Di Filippo; A Calabrò; D Giannarelli; S Carlini; F Cavaliere; F Moscarelli; R Cavaliere Journal: Cancer Date: 1989-06-15 Impact factor: 6.860
Authors: T G Zogakis; D L Bartlett; S K Libutti; D J Liewehr; S M Steinberg; D L Fraker; H R Alexander Journal: Ann Surg Oncol Date: 2001-12 Impact factor: 5.344
Authors: E M Noorda; B C Vrouenraets; O E Nieweg; A N van Geel; A M M Eggermont; B B R Kroon Journal: Eur J Surg Oncol Date: 2003-12 Impact factor: 4.424
Authors: L Romics; E A Dy; J C Coffey; D Herlihy; F Aftab; M Z Chaudhry; K Fogarty; J A O'Donnell; H P Redmond Journal: Ir J Med Sci Date: 2011-02-03 Impact factor: 1.568
Authors: David Moreno-Ramirez; Luis de la Cruz-Merino; Lara Ferrandiz; Roman Villegas-Portero; Adoracion Nieto-Garcia Journal: Oncologist Date: 2010-03-26
Authors: Ton Wang; Nicholas Osborne; John Rechtenwald; Alex Kim; Niki Matusko; Rita Mayle; Mark S Cohen Journal: Am J Surg Date: 2019-10-05 Impact factor: 2.565
Authors: A Testori; P Rutkowski; J Marsden; L Bastholt; V Chiarion-Sileni; A Hauschild; A M M Eggermont Journal: Ann Oncol Date: 2009-08 Impact factor: 32.976