Factors associated with response, survival, and limb salvage in patients undergoing isolated limb infusion Journal Article
| Authors: | Steinman, J.; Ariyan, C.; Rafferty, B.; Brady, M. S. |
| Article Title: | Factors associated with response, survival, and limb salvage in patients undergoing isolated limb infusion |
| Abstract: | Background Isolated limb infusion (ILI) is a percutaneous method of delivering regional chemotherapy to patients with recurrent tumors of the extremity. This study determines predictors of response, survival, and limb salvage. Methods Single institution data from a prospective clinical trial and subsequent ILI experience were reviewed. Limb tumor burden was assessed in melanoma patients with "high" (≥10 lesions or one lesion >3 cm) or "low" burden (<10 lesions and no lesion >3 cm). Response was assessed at 3 months from ILI. Results Between 1999 and 2011, 62 patients underwent ILI (58 melanoma, 2 Merkel cell carcinoma (MCC), 2 soft tissue sarcoma (STS)). Low tumor burden patients had more complete responses (CR) (11/23, 48%) than high tumor burden (3/32, 9%, P < 0.001); they had higher 5-year survival (69% vs. 29%, P =.007). Five-year survival rates based on response: 91% CR, 53% partial response (PR), 25% less than PR (P = 0.042, CR vs. PR). 7 patients (11%) underwent amputation due to disease progression; 3 had prior CR or PR. Conclusions Low tumor burden is a significant predictor of response in melanoma patients. Response to ILI is a significant predictor of survival. Progression of limb disease requiring amputation is not associated with any factors. © 2013 Wiley Periodicals, Inc. |
| Keywords: | adult; cancer chemotherapy; cancer survival; treatment response; aged; middle aged; limb salvage; survival rate; major clinical study; nuclear magnetic resonance imaging; follow up; lymph node dissection; prospective study; melanoma; tumor volume; melphalan; patient safety; peripheral edema; dactinomycin; papaverine; erythema; isolated limb infusion; limb pain; limb tumor; soft tissue sarcoma; regional perfusion; merkel cell carcinoma; merkel cell tumor; tumor growth; limb amputation; phase 2 clinical trial (topic); recurrent melanoma; very elderly; human; male; female; priority journal; article; limb tumor burden |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 109 |
| Issue: | 5 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2014-04-01 |
| Start Page: | 405 |
| End Page: | 409 |
| Language: | English |
| DOI: | 10.1002/jso.23519 |
| PROVIDER: | scopus |
| PUBMED: | 24318953 |
| DOI/URL: | |
| Notes: | Export Date: 1 May 2014 -- CODEN: JSONA -- Source: Scopus |
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