BACKGROUND: Isolated limb infusion (ILI) is a percutaneous method of delivering regional chemotherapy to patients with recurrent tumors of the extremity. This study determines predictors of response, survival, and limb salvage. METHODS: Single institution data from a prospective clinical trial and subsequent ILI experience were reviewed. Limb tumor burden was assessed in melanoma patients with "high" (≥10 lesions or one lesion >3 cm) or "low" burden (<10 lesions and no lesion >3 cm). Response was assessed at 3 months from ILI. RESULTS: Between 1999 and 2011, 62 patients underwent ILI (58 melanoma, 2 Merkel cell carcinoma (MCC), 2 soft tissue sarcoma (STS)). Low tumor burden patients had more complete responses (CR) (11/23, 48%) than high tumor burden (3/32, 9%, P < 0.001); they had higher 5-year survival (69% vs. 29%, P = .007). Five-year survival rates based on response: 91% CR, 53% partial response (PR), 25% less than PR (P = 0.042, CR vs. PR). 7 patients (11%) underwent amputation due to disease progression; 3 had prior CR or PR. CONCLUSIONS: Low tumor burden is a significant predictor of response in melanoma patients. Response to ILI is a significant predictor of survival. Progression of limb disease requiring amputation is not associated with any factors.
BACKGROUND: Isolated limb infusion (ILI) is a percutaneous method of delivering regional chemotherapy to patients with recurrent tumors of the extremity. This study determines predictors of response, survival, and limb salvage. METHODS: Single institution data from a prospective clinical trial and subsequent ILI experience were reviewed. Limb tumor burden was assessed in melanomapatients with "high" (≥10 lesions or one lesion >3 cm) or "low" burden (<10 lesions and no lesion >3 cm). Response was assessed at 3 months from ILI. RESULTS: Between 1999 and 2011, 62 patients underwent ILI (58 melanoma, 2 Merkel cell carcinoma (MCC), 2 soft tissue sarcoma (STS)). Low tumor burden patients had more complete responses (CR) (11/23, 48%) than high tumor burden (3/32, 9%, P < 0.001); they had higher 5-year survival (69% vs. 29%, P = .007). Five-year survival rates based on response: 91% CR, 53% partial response (PR), 25% less than PR (P = 0.042, CR vs. PR). 7 patients (11%) underwent amputation due to disease progression; 3 had prior CR or PR. CONCLUSIONS:Low tumor burden is a significant predictor of response in melanomapatients. Response to ILI is a significant predictor of survival. Progression of limb disease requiring amputation is not associated with any factors.
Authors: Marybeth S Hughes; Jonathan Zager; Mark Faries; H Richard Alexander; Richard E Royal; Bradford Wood; Junsung Choi; Kevin McCluskey; Eric Whitman; Sanjiv Agarwala; Gary Siskin; Charles Nutting; Mary Ann Toomey; Carole Webb; Tatiana Beresnev; James F Pingpank Journal: Ann Surg Oncol Date: 2015-11-23 Impact factor: 5.344
Authors: Diego J Muilenburg; Georgia M Beasley; Zachary J Thompson; Ji-Hyun Lee; Douglas S Tyler; Jonathan S Zager Journal: Ann Surg Oncol Date: 2014-09-06 Impact factor: 5.344
Authors: Stefano Guadagni; Giammaria Fiorentini; Marco Clementi; Giancarlo Palumbo; Francesco Masedu; Marcello Deraco; Giovanni De Manzoni; Alessandro Chiominto; Marco Valenti; Cristina Pellegrini Journal: Melanoma Res Date: 2017-10 Impact factor: 3.599