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

Publication ,  Journal Article
Teras, J; Kroon, HM; Miura, JT; Kenyon-Smith, T; Beasley, GM; Mullen, D; Farrow, NE; Mosca, PJ; Lowe, MC; Farley, CR; Potdar, A; Daou, H ...
Published in: Ann Surg Oncol
May 2020

BACKGROUND: 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.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

May 2020

Volume

27

Issue

5

Start / End Page

1420 / 1429

Location

United States

Related Subject Headings

  • Upper Extremity
  • United States
  • Tumor Burden
  • Treatment Outcome
  • Skin Neoplasms
  • Progression-Free Survival
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoplasm Staging
  • Neoplasm Metastasis
 

Citation

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Teras, J., Kroon, H. M., Miura, J. T., Kenyon-Smith, T., Beasley, G. M., Mullen, D., … Thompson, J. F. (2020). International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients. Ann Surg Oncol, 27(5), 1420–1429. https://doi.org/10.1245/s10434-020-08312-0
Teras, Jüri, Hidde M. Kroon, John T. Miura, Tim Kenyon-Smith, Georgia M. Beasley, Dean Mullen, Norma E. Farrow, et al. “International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients.Ann Surg Oncol 27, no. 5 (May 2020): 1420–29. https://doi.org/10.1245/s10434-020-08312-0.
Teras J, Kroon HM, Miura JT, Kenyon-Smith T, Beasley GM, Mullen D, et al. International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients. Ann Surg Oncol. 2020 May;27(5):1420–9.
Teras, Jüri, et al. “International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients.Ann Surg Oncol, vol. 27, no. 5, May 2020, pp. 1420–29. Pubmed, doi:10.1245/s10434-020-08312-0.
Teras J, Kroon HM, Miura JT, Kenyon-Smith T, Beasley GM, Mullen D, Farrow NE, Mosca PJ, Lowe MC, Farley CR, Potdar A, Daou H, Sun J, Carr M, Farma JM, Henderson MA, Speakman D, Serpell J, Delman KA, Smithers BM, Barbour A, Tyler DS, Coventry BJ, Zager JS, Thompson JF. International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients. Ann Surg Oncol. 2020 May;27(5):1420–1429.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

May 2020

Volume

27

Issue

5

Start / End Page

1420 / 1429

Location

United States

Related Subject Headings

  • Upper Extremity
  • United States
  • Tumor Burden
  • Treatment Outcome
  • Skin Neoplasms
  • Progression-Free Survival
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoplasm Staging
  • Neoplasm Metastasis