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Factors associated with response, survival, and limb salvage in patients undergoing isolated limb infusion
Author(s) -
Steinman Jonathan,
Ariyan Charlotte,
Rafferty Brian,
Brady Mary S.
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23519
Subject(s) - medicine , lower limb , surgery
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. J. Surg. Oncol. 2014 109:405–409 . © 2013 Wiley Periodicals, Inc.