Isolated limb perfusion with melphalan as treatment for regionally advanced melanoma of the limbs: Results of 60 patients treated in Finland during 2007-2018

Sanni K.A. Tulokas, Laura M. Kohtamäki, Siru P. Mäkelä, Susanna Juteau, Anders Albäck, Pirkka J. Vikatmaa, Kalle E. Mattila, Tanja K. Skyttä, Jussi P. Koivunen, Kristiina Tyynelä-Korhonen, Micaela M. Hernberg

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Isolated limb perfusion (ILP) is widely accepted as treatment for recurrent melanoma limited to the limbs. The use of ILP has decreased in recent years with the introduction of potentially effective new systemic therapies. We evaluated retrospectively if ILP still may be a treatment option in locally advanced melanoma. In Finland, ILP is centralized to the Comprehensive Cancer Center of Helsinki University Hospital. We included all ILP patients treated at our hospital between 2007 and 2018. Clinical factors and treatment outcomes were retrospectively evaluated. Altogether 60 patients received ILP. Toxicity was mostly transient. The overall response rate was 77% with 35% complete responses and 42% partial responses. The median progression-free survival (PFS) was 6.1 months (range 0.6-116.5 months) and the median melanoma-specific survival (MSS) was 29.9 months (range 3.5-138.7 months). Patients with CR had superior median PFS (19.7 months, range 2.5-116.5 vs. 4.5 months, range 0.6-39.7 months, P = 0.00003) and median MSS (median MSS not reached vs. 25.9 months, range 3.5-98.7 months, P = 0.0005) compared to other responders. Younger patients (<69 years) had longer median MSS (47.2 months, range 3.5-138.7 vs. 25.9 months, range 8.4-125.4 months, P = 0.015) compared to patients over 69 years. Treatment outcomes of Finnish ILP patients were comparable to earlier studies and some long-term survivors were observed in the group of complete responders. Median PFS and OS were longer for patients achieving a CR. Treatment was well-tolerated also among older patients.

Original languageEnglish
Pages (from-to)456-463
Number of pages8
JournalMELANOMA RESEARCH
Volume31
Issue number5
DOIs
Publication statusPublished - 2021
Publication typeA1 Journal article-refereed

Keywords

  • in-transit metastases
  • isolated limb perfusion
  • locally advanced melanoma
  • melanoma
  • predictive factors
  • satellites

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Oncology
  • Dermatology
  • Cancer Research

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