Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/128792
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Factors predicting toxicity and response following isolated limb infusion for melanoma: An international multi-centre study |
Author: | Kenyon-Smith, T. Kroon, H.M. Miura, J. Teras, J. Beasley, G. Mullen, D. Farrow, N. Mosca, P. Lowe, M. Farley, C. Potdar, A. Daou, H. Sun, J. Farma, J. Henderson, M. Speakman, D. Serpell, J. Delman, K. Smithers, M. Barbour, A. et al. |
Citation: | European Journal of Surgical Oncology, 2020; 46(11):2140-2146 |
Publisher: | Elsevier |
Issue Date: | 2020 |
ISSN: | 0748-7983 1532-2157 |
Statement of Responsibility: | Timothy J. Kenyon-Smith, Hidde M. Kroon, John T. Miura, Jüri Teras, Georgia M. Beasley, Dean Mullen, Norma E. Farrow, Paul J. Mosca, Michael C. Lowe, Clara R. Farley, Aishwarya Potdar, Hala Daou, James Sun, Jeffrey M. Farma, Michael A. Henderson, David Speakman, Jonathan Serpell, Keith A. Delman, B. Mark Smithers, Andrew Barbour, Brendon J. Coventry, Douglas S. Tyler, Jonathan S. Zager, John F. Thompson |
Abstract: | Introduction: Isolated limb infusion (ILI) is a minimally-invasive procedure for delivering high-dose regional chemotherapy to treat melanoma in-transit metastases confined to a limb. The aim of this international multi-centre study was to identify predictive factors for toxicity and response. Methods: Data of 687 patients who underwent a first ILI for melanoma in-transit metastases confined to the limb between 1992 and 2018 were collected at five Australian and four US tertiary referral centres. Results: After ILI, predictive factors for increased limb toxicity (Wieberdink grade III/IV limb toxicity, n = 192, 27.9%) were: female gender, younger age, procedures performed before 2005, lower limb procedures, higher melphalan dose, longer drug circulation and ischemia times, and increased tissue hypoxia. No patient experienced grade V toxicity (necessitating amputation). A complete response (n = 199, 28.9%) was associated with a lower stage of disease, lower burden of disease (BOD) and thinner Breslow thickness of the primary melanoma. Additionally, an overall response (combined complete and partial response, n = 441, 64.1%) was associated with female gender, Australian centres, procedures performed before 2005, lower limb procedures and lower actinomycin-D doses. On multivariate analysis, higher melphalan dose remained a predictive factor for toxicity, while lower stage of disease and lower BOD remained predictive factors for overall response. Conclusion: ILI is safe and effective to treat melanoma in-transit metastases. Predictive factors for toxicity and response identified in this study will allow improved patient selection and optimization of intra-operative parameters to increase response rates, while keeping toxicity low. |
Keywords: | in-transit disease; metastatic melanoma; Melanoma; Regional chemotherapy; Isolated limb infusion; Loco-regionally metastatic disease; Multi-centre; Toxicity; Response |
Description: | Available online 13 July 2020 |
Rights: | © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. |
DOI: | 10.1016/j.ejso.2020.06.040 |
Published version: | http://www.ejso.com/ |
Appears in Collections: | Aurora harvest 4 Surgery publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.