Australian multi-center experience outside of the Sydney Melanoma Unit of isolated limb infusion chemotherapy for melanoma

Coventry, Brendon J., Kroon, Hidde M., Giles, Mitchell H., Henderson, Michael, Speakman, David, Wall, Mark, Barbour, Andrew, Serpell, Jonathan, Paddle, Paul, Coventry, Alexander G.J., Sullivan, Thomas and Smithers, B. Mark (2014) Australian multi-center experience outside of the Sydney Melanoma Unit of isolated limb infusion chemotherapy for melanoma. Journal of Surgical Oncology, 109 8: 780-785. doi:10.1002/jso.23590


Author Coventry, Brendon J.
Kroon, Hidde M.
Giles, Mitchell H.
Henderson, Michael
Speakman, David
Wall, Mark
Barbour, Andrew
Serpell, Jonathan
Paddle, Paul
Coventry, Alexander G.J.
Sullivan, Thomas
Smithers, B. Mark
Title Australian multi-center experience outside of the Sydney Melanoma Unit of isolated limb infusion chemotherapy for melanoma
Journal name Journal of Surgical Oncology   Check publisher's open access policy
ISSN 1096-9098
0022-4790
Publication date 2014-06-01
Year available 2014
Sub-type Article (original research)
DOI 10.1002/jso.23590
Volume 109
Issue 8
Start page 780
End page 785
Total pages 6
Place of publication Hoboken, United States
Publisher John Wiley & Sons
Language eng
Formatted abstract
Introduction
Isolated limb infusion (ILI) is a minimally invasive alternative to isolated limb perfusion (ILP) for delivering high-dose regional chemotherapy to treat locally advanced limb melanoma. The current study aimed to evaluate the applicability of ILI in four Australian tertiary referral centers outside of its originating institution, the Sydney Melanoma Unit (SMU; currently known as the Melanoma Institute Australia).

Methods
Data of 131 patients, treated between 1992 and 2008 were collectively analyzed. The ILI procedures were based on the Sydney Melanoma Unit protocol using melphalan. Response was determined using the WHO criteria and toxicity was assessed using the Wieberdink scale.

Results
The median patient age was 74 years (range 28-100). Fifty-six percent were female. Overall response (OR) rate to ILI was 63% (CR 27%; PR 36%). Wieberdink toxicity grade III or higher was seen in 13%. No toxicity-related amputations occurred. Median follow-up was 24 months; median survival was 58 months. In patients with a complete response (CR), median survival was 101 months; in patients with a partial response (PR) this was 41 months (P-=-0.026). On univariate analysis a younger age, lower-limb procedures and a lower Breslow thickness of the primary melanoma were associated with a favorable response. On multivariate analysis Breslow thickness and lower-limb ILI remained significant predictors for response.

Conclusion
In this, to date, largest multi-center study of ILI for melanoma the results are comparable to other reports and demonstrate that ILI can be widely implemented and safely applied across tertiary referral centers.
Keyword Chemotherapy
Isolated limb infusion
Metastatic melanoma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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