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J Surg Oncol. 2014 Apr;109(5):405-9. doi: 10.1002/jso.23519. Epub 2013 Dec 7.

Factors associated with response, survival, and limb salvage in patients undergoing isolated limb infusion.

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  • 1Department of Surgery, Gastric, Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, New York.

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:

Merkel cell carcinoma; limb tumor burden; recurrent melanoma; soft tissue sarcoma

PMID:
24318953
[PubMed - indexed for MEDLINE]
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