Evidence map›Paper›PMID 40348927›Full record

ArticleAnnals of surgical oncology2025

Isolated Limb Infusion or Perfusion as First-Line Versus Second-Line Therapy for In-Transit Metastatic Melanoma.

Michelle M Dugan, Aleena Boby, Helana Ghali, Shaliz Aflatooni, Danielle K DePalo, Anne Huibers, Wenyi Fan, Roger Olofsson Bagge, Jonathan S Zager

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Michelle M Dugan *Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Aleena Boby *University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Helana GhaliUniversity of South Florida Morsani College of Medicine, Tampa, FL, USA.
Shaliz AflatooniUniversity of South Florida Morsani College of Medicine, Tampa, FL, USA.
Danielle K DePaloDepartment of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Anne HuibersDepartment of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Wenyi FanDepartment of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
Roger Olofsson Bagge *Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Jonathan S Zager *Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA. jonathan.zager@moffitt.org.ORCID http://orcid.org/0000-0002-6886-4468

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn-transit metastases (ITM) develops in 10% of patients with high-risk melanoma. Isolated limb infusion and perfusion (ILI/ILP) are well-established therapies for ITM, but the ideal line of therapy has not been defined. This study compared ILI/ILP as first- versus second-line therapy.

methodsAn international multi-institution retrospective study reviewed patients with unresectable ITM who underwent ILI/ILP from 2006 to 2023.

resultsThe study was comprised of 364 patients (55% female) with a median age of 71 years. Of the 364 patients, 329 (90%) were treated with ILI/ILP as first-line therapy, and 35 (10%) were treated with ILI/ILP as second-line therapy. The median follow-up period was 3 years. Lower-extremity disease was present in 85% (n = 310) of the patients. The best response for ILI/ILP as any line of therapy was 54% complete response (CR), 29 % partial response (PR), 8.2% stable disease (SD), and 9.1% progressive disease (PD). The CR/PR/SD/PD rates for first- versus second-line therapy were respectively 55%/ 29%/ 7.5%/ 8.2% versus 41%/ 26%/ 15%/ 18% (P = 0.09). As first-line therapy, ILI/ILP was associated with a significantly higher overall response rate (ORR) of 84% versus 68% (odds ratio [OR], 2.9; 95% confidence interval [CI], 1.2-6.9; P = 0.02). The comparison showed no statistical difference in median in-field progression-free survival (PFS) (10.8 vs. 8.1 months; P = 0.2), out-of-field PFS (13.5 vs. 15.3 months; P = 0.4), or overall survival (OS) (4.1 vs. 4.5 years; P = 0.7).

conclusionFor patients with unresectable melanoma ITM, ILI/ILP either as first- or second-line therapy provides high overall response rates. Although first-line therapy had a higher ORR, this did not translate to a difference in in-field PFS, indicating that ILI/ILP is indeed an effective salvage therapy also as second-line therapy.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsChemotherapy, Cancer, Regional PerfusionMelanomaSkin NeoplasmsAdultAgedAged, 80 and overExtremitiesFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateIn-transit melanomaIn-transit metastasesIsolated limb infusionIsolated limb perfusionMetastatic melanomaRegional chemotherapyTreatment line of therapy

Identifiers

PMID40348927

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.