English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Isolated limb perfusion (ILP) with delivery of high dose melphalan proved to be efficient in the treatment of in-transit metastases (ITM). Preoperative factors may carry an impact on patient outcome, including in-field or local progression-free survival (IPFS), time to distant metastases (TDM) and overall survival (OS). Materials and Methods: A retrospective analysis of 83 patients who underwent an ILP at our institution before the era of efficient upfront systemic therapy in high-risk cases. Patients were classified according to a modified M.D. Anderson score, with relevance for the outcome: 34 stage III A (patients with satellites and/or ITM), 31 stage III AB (patients with synchronous regional lymph node metastases and satellites and/or ITM), 11 at a new stage labelled III A(B) which takes into account a previous history of therapeutic regional node dissection and actual recurrence in the limb only, and 7 stage IV (metastatic cases with actual major problem of recurrence in the limb). Results: Our median follow-up time was 90.1 months (IQR 72.8-151.6). Median IPFS was 16.3 months (95% CI 9.5-78.5), median TDM 28.8 months (95% CI 15.4-69.6) and median OS 34.6 months (95% CI 21.1-59.5). The strongest significant prognostic factor regarding IPFS was LND before ILP (p=0.02). However, sex (p=0.03/0.07), LND before ILP (p=0.004/0.11) and some primary tumor characteristics (Clark level (p=0.15/0.07) and ulceration (p=0.006/0.04)) were prognostic regarding TDM and / or OS. Conclusion: ILP with melphalan can provide long-term regional and systemic tumor control in a selected group of patients and should be kept in mind for patients recurring after local surgery or radiotherapy and resistant to or ineligible for the newer systemic therapies.

Isolated Limb Perfusion in the Treatment of In-Transit Melanoma Metastases: Are There Predictive Factors for the Outcome?