Liver resection for metastatic melanoma with postoperative tumor-infiltrating lymphocyte therapy.

Published

Journal Article

BACKGROUND: Patients with metastatic melanoma to the liver (MML) have a median survival of 4 to 6 months. This study evaluated patients who underwent liver resection with intent to receive postoperative tumor-infiltrating lymphocyte (TIL) therapy. METHODS: Retrospective analysis of a prospective database identified patients with MML who underwent liver resection from 1980 to 2008. RESULTS: A total of 539 patients had MML, and 39% (204 of 539) had tumor collected for TIL. A total of 17% (35 of 204) underwent liver resection for TIL. The 3-year overall survival was 53%. Lack of extrahepatic disease (P = .026), negative margin (P = .056), and single hepatic metastasis (P = .04) predicted survival after univariate analysis. Only lack of extrahepatic disease remained a significant predictor of survival after multivariate analysis (P = .043). A total of 31% (11 of 35) underwent complete resection without TIL, and 69% (24 of 35) underwent resection with synchronous intrahepatic and extrahepatic disease with intent to receive TIL. For 9 of 11 patients (2 of 11 excluded for gene therapy), 3-year survival was 80%. A total of 4 (44%) of 9 experienced recurrence, with a median disease-free survival of 1.2 years. For 24 patients (69%) with residual disease, 3-year survival was 51% (2 of 24 excluded for gene therapy). A total of 63% (15 of 24) received postoperative TIL (3-year survival 65%), and 29% (7 of 24) did not. A total of 40% (6 of 15) had disease that partially responded to TIL; the disease of 67% (4 of 6) had not progressed at median follow-up of 55 months (range, 42-197+ months). The seven patients who did not receive TIL had a median survival of 4.6 months. CONCLUSIONS: Resection of MML with TIL should be considered because it can result in prolonged survival in a highly selected group of patients.

Full Text

Cited Authors

  • Ripley, RT; Davis, JL; Klapper, JA; Mathur, A; Kammula, U; Royal, RE; Yang, JC; Sherry, RM; Hughes, MS; Libutti, SK; White, DE; Steinberg, SM; Dudley, ME; Rosenberg, SA; Avital, I

Published Date

  • January 2010

Published In

Volume / Issue

  • 17 / 1

Start / End Page

  • 163 - 170

PubMed ID

  • 19777192

Pubmed Central ID

  • 19777192

Electronic International Standard Serial Number (EISSN)

  • 1534-4681

Digital Object Identifier (DOI)

  • 10.1245/s10434-009-0677-0

Language

  • eng

Conference Location

  • United States