A study by Michael E. Lidsky, M.D., and colleagues at Duke University Medical Center, Durham, suggests that patient, clinical, and procedural factors are unreliable predictors of in-field progressive disease after regional therapy in patients with in-transit melanoma. (Online First)
Using a prospectively maintained database, 215 patients were identified as having either undergone first-time melphalan-based isolated limb infusion (ILI) or first-time hyperthermic isolated limb perfusion (HILP) for in-transit melanoma. Of these patients, 134 underwent ILI, and 81 underwent HILP.
Of the 134 patients who underwent ILI, 43 (32.1 percent) experienced in field progressive disease. Of 81 patients who underwent HILP, 9 (11.1 percent) experienced in-field progressive disease. Procedural variables, including chemotherapeutic dosing, degree of acidosis or base deficit achieved, and peak temperature attained, were not predictors of in-field progressive disease after ILI or HIPL, the study finds.
“Defining the potential utility of molecular markers in predicting response or failure of regional therapy should be the focus of future research efforts,” the authors conclude.
JAMA Surg. Published online April 3, 2013. doi: 10.1001/jamasurg.2013.695.