Quality of Life Outcomes after Isolated Limb Infusion
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Isolated limb infusion (ILI) for the treatment of in-transit melanoma was originally described more than 10 years ago. Response rates of 45–53% have been reported in U.S. series. Long-term quality of life outcomes after this procedure have not been described. We hypothesized that ILI is rarely associated with long-term limb morbidity.
ILIs performed at our institution between July 2005 and June 2009 were reviewed. Patients were contacted cross-sectionally at 2 time points. During these interviews, response to treatment and postoperative limb function were assessed.
Thirty-two ILIs were performed during the time period. Twenty-seven patients were treated for in-transit melanoma; 5 were treated for recurrent Merkel cell carcinoma. The 30-day mortality was 0%. Three patients (9%) required fasciotomy. Durable complete responses were achieved in 41% of patients, with mean follow-up time of 19.4 ± 9.6 months after infusion; after this period, 53% reported progression of disease. The most common postprocedure symptoms were edema (88%), numbness (59%), and pain (59%). By 3 months and at the time of last follow-up, the most common symptoms were edema (82%), numbness (65%), and stiffness (35%). No patients reported impaired limb function at the time of last follow-up compared to baseline. Median survival was 19.2 ± 4.2 months after infusion.
ILI for melanoma and Merkel cell carcinoma is associated with postprocedure symptoms in most patients, most commonly edema, color change, and numbness. At last follow-up, no ILI patients had residual functional impairment in the treated limb.
- Creech O Jr, Krementz ET, Ryan RF, et al. Chemotherapy of cancer: regional perfusion ultilizing an extracorporeal circuit. Ann Surg. 1958;148:616–32. CrossRef
- Thompson JF, Kam PC, Waugh RC, Harman CR. Isolated limb infusion with cytotoxic agents: a simple alternative to isolated limb perfusion. Semin Surg Oncol. 1998;14:238–47. CrossRef
- Beasley GM, Peterson RP, Yoo J, et al. Isolated limb infusion for in-transit malignant melanoma of the extremity: a well tolerated but less effective alternative to hyperthermic isolated limb perfusion. Ann Surg Oncol. 2008;15:2195–205. CrossRef
- Brady MS, Brown K, Patel A, et al. A phase II trial of isolated limb infusion with melphalan and dactinomycin for regional melanoma and soft tissue sarcoma of the extremity. Ann Surg Oncol. 2006;13:1123–9. CrossRef
- Beasley GM, Caudle A, Petersen RP, et al. A multi-institutional experience of isolated limb infusion: defining response and toxicity in the U.S. J Am Coll Surg. 2009;208:706–15. CrossRef
- Santillan AA, Delman KA, Beasley GM, et al. Predictive factors of regional toxicity and serum creatine phosphokinase levels after isolated limb infusion for melanoma: a multi-institutional analysis. Ann Surg Oncol. 2009;16:2570–8. CrossRef
- Wieberdink J, Benckhuysen C, Braat RP, et al. Dosimetry in isolated perfusion of the limbs by assessment of perfused tissue volume and grading of toxic tissue reactions. Eur J Cancer Clin Oncol. 1982;18:905–10. CrossRef
- Huismans AE, Kroon HM, Kam PC, Thompson JF. Does increased experience with isolated limb infusion for advanced limb melanoma influence outcome? A comparison of two treatment periods at a single institution. Ann Surg Oncol. 2011:1877–83.
- Noorda EM, van Kreij RH, Vrouenraets BC, et al. The health-related quality of life of long-term survivors of melanoma treated with isolated limb perfusion. Eur J Surg Oncol. 2007;33:776–82. CrossRef
- Vrouenraets BC, in’t Veld GJ, Nieweg OE, et al. Long-term functional morbidity after mild hyperthermic isolated limb perfusion with melphalan. Eur J Surg Oncol. 1999;25:503–8.
- Van Geel AN, van Wijk J, Wieberdink J. Functional morbidity after regional isolated perfusion of the limb for melanoma. Cancer. 1989;63:1092–6. CrossRef
- Knorr C, Melling N, Goehl J, et al. Long-term functional outcome after hyperthermic isolated limb perfusion (HILP). Int J Hyperthermia. 2008;24:409–14. CrossRef
- Olieman AF, Schraffordt Koops H, Geertzen JH, et al. Functional morbidity of hyperthermic isolated regional perfusion of the extremities. Ann Surg Oncol. 1994;1:382–8. CrossRef
- Quality of Life Outcomes after Isolated Limb Infusion
Annals of Surgical Oncology
Volume 19, Issue 5 , pp 1373-1378
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors