title: Safety and efficacy of isolated limb perfusion in elderly melanoma patients.
abstract: BACKGROUND
  Older patients are assumed to have a higher risk of complications from isolated limb perfusion (ILP). A study was performed evaluating the safety and efficacy of ILP in patients older than 75 years with advanced melanoma of the limbs.
  
  
  METHODS
  A total of 218 therapeutic ILPs with melphalan with or without tumor necrosis factor alpha were performed in 202 patients with advanced measurable melanoma and were analyzed retrospectively. Fifty-three patients (28%) were 75 years or older.
  
  
  RESULTS
  Complete response rates were 56% for those older than 75 years and 58% for the younger group (P =.79). Locoregional relapse occurred in 56% of the older group versus 51% in the younger group (P =.61). Limb toxicity, systemic toxicity, local complications, and long-term morbidity were similar in both age groups. Perioperative mortality was low, with one procedure-related death in the older group. Older patients stayed in the hospital for a median of 23 days (younger patients, 19 days; P <.01).
  
  
  CONCLUSIONS
  ILP results in similar response rates in the elderly with recurrent melanoma, without increased toxicity, complications, or long-term morbidity compared with younger patients. Older age in itself is not a contraindication for ILP.
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. e.noorda@nki.nl
authors.forename: E M
authors.initials: EM
authors.lastname: Noorda
authors.forename: B C
authors.initials: BC
authors.lastname: Vrouenraets
authors.forename: O E
authors.initials: OE
authors.lastname: Nieweg
authors.forename: A N
authors.initials: AN
authors.lastname: van Geel
authors.forename: A M M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: B B R
authors.initials: BB
authors.lastname: Kroon
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005121:Extremities; D005260:Female; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014409:Tumor Necrosis Factor-alpha; D008558:Melphalan