International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients

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dc.contributor.authorTeras, J.
dc.contributor.authorKroon, H.M.
dc.contributor.authorMiura, J.T.
dc.contributor.authorKenyon-Smith, T.
dc.contributor.authorBeasley, G.M.
dc.contributor.authorMullen, D.
dc.contributor.authorFarrow, N.E.
dc.contributor.authorMosca, P.J.
dc.contributor.authorLowe, M.C.
dc.contributor.authorFarley, C.R.
dc.contributor.authorPotdar, A.
dc.contributor.authorDaou, H.
dc.contributor.authorSun, J.
dc.contributor.authorCarr, M.
dc.contributor.authorFarma, J.M.
dc.contributor.authorHenderson, M.A.
dc.contributor.authorSpeakman, D.
dc.contributor.authorSerpell, J.
dc.contributor.authorDelman, K.A.
dc.contributor.authorSmithers, B.M.
dc.contributor.authoret al.
dc.date.issued2020
dc.description.abstractBACKGROUND:Isolated limb infusion (ILI) is used to treat in-transit melanoma metastases confined to an extremity. However, little is known about its safety and efficacy in octogenarians and nonagenarians (ON). PATIENTS AND METHODS:ON patients (≥ 80 years) who underwent a first ILI for American Joint Committee on Cancer seventh edition stage IIIB/IIIC melanoma between 1992 and 2018 at nine international centers were included and compared with younger patients (< 80 years). A cytotoxic drug combination of melphalan and actinomycin-D was used. RESULTS:Of the 687 patients undergoing a first ILI, 160 were ON patients (median age 84 years; range 80-100 years). Compared with the younger cohort (n = 527; median age 67 years; range 29-79 years), ON patients were more frequently female (70.0% vs. 56.9%; p = 0.003), had more stage IIIB disease (63.8 vs. 53.3%; p = 0.02), and underwent more upper limb ILIs (16.9% vs. 9.5%; p = 0.009). ON patients experienced similar Wieberdink limb toxicity grades III/IV (25.0% vs. 29.2%; p = 0.45). No toxicity-related limb amputations were performed. Overall response for ON patients was 67.3%, versus 64.6% for younger patients (p = 0.53). Median in-field progression-free survival was 9 months for both groups (p = 0.88). Median distant progression-free survival was 36 versus 23 months (p = 0.16), overall survival was 29 versus 40 months (p < 0.0001), and melanoma-specific survival was 46 versus 78 months (p = 0.0007) for ON patients compared with younger patients, respectively. CONCLUSIONS:ILI in ON patients is safe and effective with similar response and regional control rates compared with younger patients. However, overall and melanoma-specific survival are shorter.
dc.description.statementofresponsibilityJüri Teras, Hidde M. Kroon, John T. Miura, Tim Kenyon-Smith, Georgia M. Beasley, Dean Mullen, Norma E. Farrow, Paul J. Mosca, Michael C. Lowe, Clara R. Farley, Aishwarya Potdar, Hala Daou, James Sun, Michael Carr, Jeffrey M. Farma, Michael A. Henderson, David Speakman, Jonathan Serpell, Keith A. Delman, B. Mark Smithers, Andrew Barbour, Douglas S. Tyler, Brendon J. Coventry, Jonathan S. Zager, and John F. Thompson
dc.identifier.citationAnnals of Surgical Oncology, 2020; 27(5):1420-1429
dc.identifier.doi10.1245/s10434-020-08312-0
dc.identifier.issn1068-9265
dc.identifier.issn1534-4681
dc.identifier.orcidKroon, H.M. [0000-0002-8923-7527]
dc.identifier.orcidCoventry, B.J. [0000-0002-3596-7735]
dc.identifier.urihttps://hdl.handle.net/2440/140418
dc.language.isoen
dc.publisherSPRINGER
dc.rights© Society of Surgical Oncology 2020
dc.source.urihttps://doi.org/10.1245/s10434-020-08312-0
dc.subjectIsolated limb infusion (ILI)
dc.subjectin-transit melanoma metastases
dc.subject.meshLower Extremity
dc.subject.meshUpper Extremity
dc.subject.meshHumans
dc.subject.meshMelanoma
dc.subject.meshSkin Neoplasms
dc.subject.meshNeoplasm Metastasis
dc.subject.meshNeoplasm, Residual
dc.subject.meshMelphalan
dc.subject.meshDactinomycin
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols
dc.subject.meshNeoplasm Staging
dc.subject.meshTreatment Outcome
dc.subject.meshLength of Stay
dc.subject.meshTumor Burden
dc.subject.meshAged, 80 and over
dc.subject.meshUnited States
dc.subject.meshAustralia
dc.subject.meshFemale
dc.subject.meshMale
dc.subject.meshChemotherapy, Cancer, Regional Perfusion
dc.subject.meshProgression-Free Survival
dc.titleInternational Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients
dc.typeJournal article
pubs.publication-statusPublished

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