BACKGROUND: At this time little is known about prognostic factors for tumor response and subsequent limb recurrence-free interval in patients suffering from advanced melanoma of the limbs who were treated with regional isolated perfusion. METHODS: A retrospective analysis was done, with a logistic regression model and a Cox proportional hazard analysis, looking at possible patient-, tumor-, and treatment-related prognostic factors in all 120 patients with advanced melanoma of the limbs who were treated with regional isolated perfusion with melphalan in the period 1978 to 1990 at our institutions. RESULTS: Complete remission was achieved in 65 patients (54%) with a median duration of 9+ months (range, 1 to 97+ months), and partial remission was seen in 30 patients (25%). Prognostic factors for complete remission were multiple versus single perfusion schedule, the absence of regional node involvement, and leg versus other tumor sites. The 3-year limb recurrence-free interval was 38%. Factors associated with this interval were one as opposed to more than one lesion, complete remission after perfusion, and female sex. Patients exhibiting complete remission after perfusion had a better overall 3-year survival rate than had patients without complete remission (60% vs 35%; p = 0.0012). CONCLUSIONS: In the present study prognostic factors for tumor response and limb recurrence-free interval could be determined. A multiple perfusion schedule may be more effective in providing complete remission in patients undergoing regional isolated perfusion than single perfusions are.
BACKGROUND: At this time little is known about prognostic factors for tumor response and subsequent limb recurrence-free interval in patients suffering from advanced melanoma of the limbs who were treated with regional isolated perfusion. METHODS: A retrospective analysis was done, with a logistic regression model and a Cox proportional hazard analysis, looking at possible patient-, tumor-, and treatment-related prognostic factors in all 120 patients with advanced melanoma of the limbs who were treated with regional isolated perfusion with melphalan in the period 1978 to 1990 at our institutions. RESULTS: Complete remission was achieved in 65 patients (54%) with a median duration of 9+ months (range, 1 to 97+ months), and partial remission was seen in 30 patients (25%). Prognostic factors for complete remission were multiple versus single perfusion schedule, the absence of regional node involvement, and leg versus other tumor sites. The 3-year limb recurrence-free interval was 38%. Factors associated with this interval were one as opposed to more than one lesion, complete remission after perfusion, and female sex. Patients exhibiting complete remission after perfusion had a better overall 3-year survival rate than had patients without complete remission (60% vs 35%; p = 0.0012). CONCLUSIONS: In the present study prognostic factors for tumor response and limb recurrence-free interval could be determined. A multiple perfusion schedule may be more effective in providing complete remission in patients undergoing regional isolated perfusion than single perfusions are.
Authors: Christy Y Chai; Jeremiah L Deneve; Georgia M Beasley; Suroosh S Marzban; Y Ann Chen; Bhupendra Rawal; Stephen R Grobmyer; Steven N Hochwald; Douglas S Tyler; Jonathan S Zager Journal: Ann Surg Oncol Date: 2011-12-06 Impact factor: 5.344
Authors: Amanda K Raymond; Georgia M Beasley; Gloria Broadwater; Christina K Augustine; James C Padussis; Ryan Turley; Bercedis Peterson; Hilliard Seigler; Scott K Pruitt; Douglas S Tyler Journal: J Am Coll Surg Date: 2011-04-13 Impact factor: 6.113
Authors: Dirk J Grünhagen; Flavia Brunstein; Wilfried J Graveland; Albertus N van Geel; Johannes H W de Wilt; Alexander M M Eggermont Journal: Ann Surg Date: 2004-12 Impact factor: 12.969
Authors: H Richard Alexander; Douglas L Fraker; David L Bartlett; Steven K Libutti; Seth M Steinberg; Perry Soriano; Tatiana Beresnev Journal: J Clin Oncol Date: 2009-11-09 Impact factor: 44.544