Title | Factors associated with response, survival, and limb salvage in patients undergoing isolated limb infusion. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Steinman J, Ariyan C, Rafferty B, Brady MS |
Journal | J Surg Oncol |
Volume | 109 |
Issue | 5 |
Pagination | 405-9 |
Date Published | 2014 Apr |
ISSN | 1096-9098 |
Keywords | Adult, Aged, Amputation, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Merkel Cell, Chemotherapy, Cancer, Regional Perfusion, Dactinomycin, Disease Progression, Drug Administration Schedule, Extremities, Female, Humans, Kaplan-Meier Estimate, Limb Salvage, Male, Melanoma, Melphalan, Middle Aged, Neoplasm Staging, Prospective Studies, Retrospective Studies, Sarcoma, Skin Neoplasms, Treatment Outcome, Tumor Burden |
Abstract | 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. |
DOI | 10.1002/jso.23519 |
Alternate Journal | J Surg Oncol |
PubMed ID | 24318953 |
Submitted by kej2006 on June 6, 2018 - 4:09pm