Related Experiment Video
Updated: Sep 20, 2025
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Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity
Published on: January 31, 2025
591
Isolated Limb Infusion/Perfusion for Unresectable Acral Versus Non-Acral Melanoma In-Transit Metastases
Michelle M Dugan1, Jacob Israeli2, Nicholas Chin2
1Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Annals of Surgical Oncology
|May 24, 2025
Summary
Acral lentiginous melanoma (ALM) shows similar local control with isolated limb infusion/perfusion (ILI/ILP) compared to other melanomas. However, ALM has poorer survival outcomes, indicating a need for improved systemic therapies alongside ILI/ILP.
Area of Science:
- Oncology
- Surgical Oncology
- Dermatology
Background:
- Acral lentiginous melanoma (ALM) presents a poorer prognosis and a poorly understood genetic profile compared to non-ALM subtypes, limiting therapeutic options.
- This study investigates the comparative outcomes of isolated limb infusion or perfusion (ILI/ILP) in patients diagnosed with ALM versus non-ALM.
Purpose of the Study:
- To compare the efficacy of ILI/ILP in managing acral lentiginous melanoma (ALM) versus non-ALM.
- To evaluate locoregional disease control and survival outcomes between ALM and non-ALM patients treated with ILI/ILP.
Main Methods:
- A multi-institution retrospective review was conducted.
- Patients with unresectable melanoma in-transit metastases (ITM) treated with ILI/ILP between 2002 and 2023 were included.
- Data from 364 patients (84 ALM, 280 non-ALM) were analyzed.
Main Results:
- ALM tumors exhibited greater Breslow thickness and ulceration compared to non-ALM.
- No significant differences were observed in complete or overall response rates between ALM and non-ALM groups.
- While in-field progression-free survival (PFS) and overall survival were similar, ALM showed significantly shorter out-of-field PFS and disease-specific survival.
Conclusions:
- Isolated limb infusion or perfusion (ILI/ILP) achieves comparable locoregional disease control for both ALM and non-ALM in-transit metastases.
- The poorer disease-specific survival and out-of-field PFS in ALM patients suggest a more aggressive tumor biology.
- These findings highlight a potential role for systemic therapies in conjunction with ILI/ILP to enhance both local and distant disease control in ALM.
