Isolated limb perfusion for unresectable extremity cutaneous squamous cell carcinoma; an effective limb saving strategy
Menée à partir de données portant sur 30 patients atteints d'un carcinome épidermoïde cutané des extrémités, non résécable et de stade localement avancé (âge médian : 71 ans ; durée médiane de suivi : 25 mois), cette étude évalue l'efficacité, du point de vue des taux de réponse et de la survie globale à 2 ans, du TNF alpha et du melphalan en perfusion isolée du membre atteint
Background : A small minority of patients present with locally advanced cutaneous Squamous Cell Carcinoma (cSCC). The aim of this study was to evaluate the effectiveness of Tumour necrosis factor
α (TNF) and melphalan based isolated limb perfusion (TM-ILP) as a limb saving strategy for locally advanced extremity cSCC. Methods
:
A retrospective search from prospectively maintained databases, at two tertiary referral centers, was performed to identify patients treated with TM-ILP for locally advanced cSSC of an extremity between 2000 and 2015. Results
:
A total of 30 patients treated with TM-ILP for cSCC were identified, with a median age of 71 years (36
–92) and 50% female. Response could not be evaluated in 3 patients. After a median follow up of 25 months, the overall response rate was 81% (n = 22), with 16 patients having a complete response (CR, 59%). A total of 7 patients developed local recurrence, with a median time to recurrence of 9 months (Interquartile Range 7–10). Progressive disease was observed in 5 patients (19%). Limb salvage rate was 80%. The overall 2-year survival was 67%. Conclusions : TM-ILP should be considered as an option in patients with locally advanced cSCC in specialised centers, resulting in a high limb salvage rate.