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A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities

  • Melanomas
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Hyperthermic isolated limb perfusion (HILP) or isolated limb infusion (ILI) are well-accepted regional chemotherapy techniques for in-transit melanoma of extremity. The role and efficacy of repeat regional chemotherapy for recurrence and which salvage procedure is better remains debatable. We aimed to compare toxicities and clinical outcomes by procedure types and the sequence.

Methods

Data from 44 patients, who underwent repeat HILPs or ILIs from 3 institutions beginning 1997 to 2010, were retrospectively reviewed. Regional toxicity assessed by Wieberdink grade, systemic toxicity assessed by serum creatine phosphokinase level, length of hospital stay (LOS), response rates at 3 months after the procedure, and time to in-field progression (TTP) were analyzed.

Results

Of 44 patients, 46% were men and 54% women with a median age of 66 (range 29–85) years at diagnosis. The median follow-up was 21.4 (range 4–153) months. Of 70 ILIs and 28 HILPs, the following groups were identified: group A, ILI → ILI (n = 25); group B, ILI → HILP (n = 10); group C, HILP → ILI (n = 12); and group D, HILP → HILP (n = 3). The comparison of Wieberdink grade, serum creatine phosphokinase level, LOS, and response rate between procedures (HILP vs. ILI), between sequence (initial vs. repeat), and among their interactions showed no statistically significant differences. TTP after initial procedure did not differ between HILP and ILI (P = 0.08), and no survival difference was seen (P = 0.65) when TTP after repeat procedure was compared.

Conclusions

Most patients tolerated repeat regional chemotherapy without increased toxicity or LOS. No statistical difference in clinical outcomes was noted when comparing repeat procedures, even though repeat HILPs showed higher complete response compared to repeat ILIs.

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Authors and Affiliations

  1. Department of Surgery, San Antonio Military Medical Center, San Antonio, TX, USA

    Christy Y. Chai MD

  2. Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Jeremiah L. Deneve DO, Suroosh S. Marzban BA & Jonathan S. Zager MD

  3. Departments of Oncological Sciences and Surgery, University of South Florida, Tampa, FL, USA

    Jeremiah L. Deneve DO, Suroosh S. Marzban BA & Jonathan S. Zager MD

  4. Department of Surgery, Duke University, Durham, NC, USA

    Georgia M. Beasley MD & Douglas S. Tyler MD

  5. Department of Biostatistics, Moffitt Cancer Center, Tampa, FL, USA

    Y. Ann Chen PhD & Bhupendra Rawal MS

  6. Department of Surgery, University of Florida, Gainesville, FL, USA

    Stephen R. Grobmyer MD & Steven N. Hochwald MD

Authors
  1. Christy Y. Chai MD
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  2. Jeremiah L. Deneve DO
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  3. Georgia M. Beasley MD
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  4. Suroosh S. Marzban BA
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  5. Y. Ann Chen PhD
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  6. Bhupendra Rawal MS
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  7. Stephen R. Grobmyer MD
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  8. Steven N. Hochwald MD
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  9. Douglas S. Tyler MD
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  10. Jonathan S. Zager MD
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Corresponding author

Correspondence to Jonathan S. Zager MD.

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Chai, C.Y., Deneve, J.L., Beasley, G.M. et al. A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities. Ann Surg Oncol 19, 1637–1643 (2012). https://doi.org/10.1245/s10434-011-2151-z

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  • DOI: https://doi.org/10.1245/s10434-011-2151-z

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