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Patients with in‐transit melanoma metastases have comparable survival outcomes following isolated limb infusion or intralesional PV‐10—A propensity score matched, single center study
Author(s) -
Read Tavis,
Fayers Warren,
Thomas Janine,
Wagels Michael,
Barbour Andrew,
Mark Smithers B.
Publication year - 2019
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.25373
Subject(s) - medicine , propensity score matching , melanoma , surgery , multivariate analysis , proportional hazards model , cohort , logistic regression , single center , overall survival , survival analysis , gastroenterology , cancer research
Background and Objective Isolated limb infusion (ILI) and intralesional PV‐10 are well described locoregional therapies for in‐transit melanoma. The objective of this study was to assess the effect of these treatments on survival outcomes within a cohort matched for key characteristics. Methods Patients were treated using ILI or intralesional PV‐10 at a single institution and the data prospectively recorded. Propensity score matching was performed using key covariates within a logistic regression model. The primary outcome was the melanoma‐specific survival. Results Seventy‐two patients nonrandomized were successfully matched. Both treatments produced similar best overall responses. The median melanoma‐specific survival (MSS) was 74.4 months from ILI and 36.4 months from PV‐10 treatments ( P = 0.164). Within the ILI subgroup, the 12‐, 24‐, 36‐ and 60‐month MSS rates were 85.3%, 75.3%, 60.1%, and 60.1%, respectively. From the time of PV‐10 the corresponding 12‐, 24‐, 36‐, and 60‐month MSS rates were 82.6%, 70.0%, 53.9%, and 35.9%. On multivariate analysis, there was a significant difference in survival comparing completely with noncomplete responders ( P = 0.031). Conclusions These findings demonstrate that ILI and PV‐10 treatments for in‐transit disease produce comparable long‐term survival. Both therapies have reproducible response rates and predominantly localized and tolerable side‐effects.