Teras, J.Kroon, H.M.Miura, J.T.Kenyon-Smith, T.Beasley, G.M.Mullen, D.Farrow, N.E.Mosca, P.J.Lowe, M.C.Farley, C.R.Potdar, A.Daou, H.Sun, J.Carr, M.Farma, J.M.Henderson, M.A.Speakman, D.Serpell, J.Delman, K.A.Smithers, B.M.et al.2024-02-122024-02-122020Annals of Surgical Oncology, 2020; 27(5):1420-14291068-92651534-4681https://hdl.handle.net/2440/140418BACKGROUND: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.en© Society of Surgical Oncology 2020Isolated limb infusion (ILI)in-transit melanoma metastasesLower ExtremityUpper ExtremityHumansMelanomaSkin NeoplasmsNeoplasm MetastasisNeoplasm, ResidualMelphalanDactinomycinAntineoplastic Combined Chemotherapy ProtocolsNeoplasm StagingTreatment OutcomeLength of StayTumor BurdenAged, 80 and overUnited StatesAustraliaFemaleMaleChemotherapy, Cancer, Regional PerfusionProgression-Free SurvivalJournal article10.1245/s10434-020-08312-02023-11-20524228Kroon, H.M. [0000-0002-8923-7527]Coventry, B.J. [0000-0002-3596-7735]