Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis
Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherap...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Santillan, Alfredo A. [verfasserIn] Delman, Keith A. [verfasserIn] Beasley, Georgia M. [verfasserIn] Mosca, Paul J. [verfasserIn] Hochwald, Steven N. [verfasserIn] Grobmyer, Stephen R. [verfasserIn] Andtbacka, Robert H. [verfasserIn] Noyes, R. Dirk [verfasserIn] Kane, John M. [verfasserIn] Ross, Merrick I. [verfasserIn] Tyler, Douglas S. [verfasserIn] Zager, Jonathan S. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2009 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Annals of surgical oncology - Berlin [u.a.] : Springer, 1994, 16(2009), 9 vom: 19. Juni, Seite 2570-2578 |
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| Übergeordnetes Werk: |
volume:16 ; year:2009 ; number:9 ; day:19 ; month:06 ; pages:2570-2578 |
| Links: |
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| DOI / URN: |
10.1245/s10434-009-0563-9 |
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| Katalog-ID: |
SPR009934162 |
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| 100 | 1 | |a Santillan, Alfredo A. |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis |
| 264 | 1 | |c 2009 | |
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| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. | ||
| 650 | 4 | |a Papaverine |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Ideal Body Weight |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Isolate Limb Infusion |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Limb Volume |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hyperthermic Isolate Limb Perfusion |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Delman, Keith A. |e verfasserin |4 aut | |
| 700 | 1 | |a Beasley, Georgia M. |e verfasserin |4 aut | |
| 700 | 1 | |a Mosca, Paul J. |e verfasserin |4 aut | |
| 700 | 1 | |a Hochwald, Steven N. |e verfasserin |4 aut | |
| 700 | 1 | |a Grobmyer, Stephen R. |e verfasserin |4 aut | |
| 700 | 1 | |a Andtbacka, Robert H. |e verfasserin |4 aut | |
| 700 | 1 | |a Noyes, R. Dirk |e verfasserin |4 aut | |
| 700 | 1 | |a Kane, John M. |e verfasserin |4 aut | |
| 700 | 1 | |a Ross, Merrick I. |e verfasserin |4 aut | |
| 700 | 1 | |a Tyler, Douglas S. |e verfasserin |4 aut | |
| 700 | 1 | |a Zager, Jonathan S. |e verfasserin |4 aut | |
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2009 |
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10.1245/s10434-009-0563-9 doi (DE-627)SPR009934162 (SPR)s10434-009-0563-9-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Santillan, Alfredo A. verfasserin aut Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. Papaverine (dpeaa)DE-He213 Ideal Body Weight (dpeaa)DE-He213 Isolate Limb Infusion (dpeaa)DE-He213 Limb Volume (dpeaa)DE-He213 Hyperthermic Isolate Limb Perfusion (dpeaa)DE-He213 Delman, Keith A. verfasserin aut Beasley, Georgia M. verfasserin aut Mosca, Paul J. verfasserin aut Hochwald, Steven N. verfasserin aut Grobmyer, Stephen R. verfasserin aut Andtbacka, Robert H. verfasserin aut Noyes, R. Dirk verfasserin aut Kane, John M. verfasserin aut Ross, Merrick I. verfasserin aut Tyler, Douglas S. verfasserin aut Zager, Jonathan S. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 9 vom: 19. Juni, Seite 2570-2578 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:9 day:19 month:06 pages:2570-2578 https://dx.doi.org/10.1245/s10434-009-0563-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 9 19 06 2570-2578 |
| spelling |
10.1245/s10434-009-0563-9 doi (DE-627)SPR009934162 (SPR)s10434-009-0563-9-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Santillan, Alfredo A. verfasserin aut Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. Papaverine (dpeaa)DE-He213 Ideal Body Weight (dpeaa)DE-He213 Isolate Limb Infusion (dpeaa)DE-He213 Limb Volume (dpeaa)DE-He213 Hyperthermic Isolate Limb Perfusion (dpeaa)DE-He213 Delman, Keith A. verfasserin aut Beasley, Georgia M. verfasserin aut Mosca, Paul J. verfasserin aut Hochwald, Steven N. verfasserin aut Grobmyer, Stephen R. verfasserin aut Andtbacka, Robert H. verfasserin aut Noyes, R. Dirk verfasserin aut Kane, John M. verfasserin aut Ross, Merrick I. verfasserin aut Tyler, Douglas S. verfasserin aut Zager, Jonathan S. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 9 vom: 19. Juni, Seite 2570-2578 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:9 day:19 month:06 pages:2570-2578 https://dx.doi.org/10.1245/s10434-009-0563-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 9 19 06 2570-2578 |
| allfields_unstemmed |
10.1245/s10434-009-0563-9 doi (DE-627)SPR009934162 (SPR)s10434-009-0563-9-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Santillan, Alfredo A. verfasserin aut Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. Papaverine (dpeaa)DE-He213 Ideal Body Weight (dpeaa)DE-He213 Isolate Limb Infusion (dpeaa)DE-He213 Limb Volume (dpeaa)DE-He213 Hyperthermic Isolate Limb Perfusion (dpeaa)DE-He213 Delman, Keith A. verfasserin aut Beasley, Georgia M. verfasserin aut Mosca, Paul J. verfasserin aut Hochwald, Steven N. verfasserin aut Grobmyer, Stephen R. verfasserin aut Andtbacka, Robert H. verfasserin aut Noyes, R. Dirk verfasserin aut Kane, John M. verfasserin aut Ross, Merrick I. verfasserin aut Tyler, Douglas S. verfasserin aut Zager, Jonathan S. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 9 vom: 19. Juni, Seite 2570-2578 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:9 day:19 month:06 pages:2570-2578 https://dx.doi.org/10.1245/s10434-009-0563-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 9 19 06 2570-2578 |
| allfieldsGer |
10.1245/s10434-009-0563-9 doi (DE-627)SPR009934162 (SPR)s10434-009-0563-9-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Santillan, Alfredo A. verfasserin aut Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. Papaverine (dpeaa)DE-He213 Ideal Body Weight (dpeaa)DE-He213 Isolate Limb Infusion (dpeaa)DE-He213 Limb Volume (dpeaa)DE-He213 Hyperthermic Isolate Limb Perfusion (dpeaa)DE-He213 Delman, Keith A. verfasserin aut Beasley, Georgia M. verfasserin aut Mosca, Paul J. verfasserin aut Hochwald, Steven N. verfasserin aut Grobmyer, Stephen R. verfasserin aut Andtbacka, Robert H. verfasserin aut Noyes, R. Dirk verfasserin aut Kane, John M. verfasserin aut Ross, Merrick I. verfasserin aut Tyler, Douglas S. verfasserin aut Zager, Jonathan S. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 9 vom: 19. Juni, Seite 2570-2578 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:9 day:19 month:06 pages:2570-2578 https://dx.doi.org/10.1245/s10434-009-0563-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 9 19 06 2570-2578 |
| allfieldsSound |
10.1245/s10434-009-0563-9 doi (DE-627)SPR009934162 (SPR)s10434-009-0563-9-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Santillan, Alfredo A. verfasserin aut Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. Papaverine (dpeaa)DE-He213 Ideal Body Weight (dpeaa)DE-He213 Isolate Limb Infusion (dpeaa)DE-He213 Limb Volume (dpeaa)DE-He213 Hyperthermic Isolate Limb Perfusion (dpeaa)DE-He213 Delman, Keith A. verfasserin aut Beasley, Georgia M. verfasserin aut Mosca, Paul J. verfasserin aut Hochwald, Steven N. verfasserin aut Grobmyer, Stephen R. verfasserin aut Andtbacka, Robert H. verfasserin aut Noyes, R. Dirk verfasserin aut Kane, John M. verfasserin aut Ross, Merrick I. verfasserin aut Tyler, Douglas S. verfasserin aut Zager, Jonathan S. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 9 vom: 19. Juni, Seite 2570-2578 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:9 day:19 month:06 pages:2570-2578 https://dx.doi.org/10.1245/s10434-009-0563-9 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 9 19 06 2570-2578 |
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Enthalten in Annals of surgical oncology 16(2009), 9 vom: 19. Juni, Seite 2570-2578 volume:16 year:2009 number:9 day:19 month:06 pages:2570-2578 |
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Papaverine Ideal Body Weight Isolate Limb Infusion Limb Volume Hyperthermic Isolate Limb Perfusion |
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Santillan, Alfredo A. @@aut@@ Delman, Keith A. @@aut@@ Beasley, Georgia M. @@aut@@ Mosca, Paul J. @@aut@@ Hochwald, Steven N. @@aut@@ Grobmyer, Stephen R. @@aut@@ Andtbacka, Robert H. @@aut@@ Noyes, R. Dirk @@aut@@ Kane, John M. @@aut@@ Ross, Merrick I. @@aut@@ Tyler, Douglas S. @@aut@@ Zager, Jonathan S. @@aut@@ |
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Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. 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|
| author |
Santillan, Alfredo A. |
| spellingShingle |
Santillan, Alfredo A. ddc 610 bkl 44.81 bkl 44.65 misc Papaverine misc Ideal Body Weight misc Isolate Limb Infusion misc Limb Volume misc Hyperthermic Isolate Limb Perfusion Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis |
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Santillan, Alfredo A. |
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electronic Article |
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610 - Medicine & health |
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Not Illustrated |
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1534-4681 |
| topic_title |
610 ASE 44.81 bkl 44.65 bkl Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis Papaverine (dpeaa)DE-He213 Ideal Body Weight (dpeaa)DE-He213 Isolate Limb Infusion (dpeaa)DE-He213 Limb Volume (dpeaa)DE-He213 Hyperthermic Isolate Limb Perfusion (dpeaa)DE-He213 |
| topic |
ddc 610 bkl 44.81 bkl 44.65 misc Papaverine misc Ideal Body Weight misc Isolate Limb Infusion misc Limb Volume misc Hyperthermic Isolate Limb Perfusion |
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ddc 610 bkl 44.81 bkl 44.65 misc Papaverine misc Ideal Body Weight misc Isolate Limb Infusion misc Limb Volume misc Hyperthermic Isolate Limb Perfusion |
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ddc 610 bkl 44.81 bkl 44.65 misc Papaverine misc Ideal Body Weight misc Isolate Limb Infusion misc Limb Volume misc Hyperthermic Isolate Limb Perfusion |
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Elektronische Aufsätze Aufsätze Elektronische Ressource |
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Annals of surgical oncology |
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343969947 |
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610 - Medicine & health |
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Annals of surgical oncology |
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(DE-627)343969947 (DE-600)2074021-9 |
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Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis |
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(DE-627)SPR009934162 (SPR)s10434-009-0563-9-e |
| title_full |
Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis |
| author_sort |
Santillan, Alfredo A. |
| journal |
Annals of surgical oncology |
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Annals of surgical oncology |
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eng |
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600 - Technology |
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2009 |
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txt |
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2570 |
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Santillan, Alfredo A. Delman, Keith A. Beasley, Georgia M. Mosca, Paul J. Hochwald, Steven N. Grobmyer, Stephen R. Andtbacka, Robert H. Noyes, R. Dirk Kane, John M. Ross, Merrick I. Tyler, Douglas S. Zager, Jonathan S. |
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16 |
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610 ASE 44.81 bkl 44.65 bkl |
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Elektronische Aufsätze |
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Santillan, Alfredo A. |
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10.1245/s10434-009-0563-9 |
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610 |
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verfasserin |
| title_sort |
predictive factors of regional toxicity and serum creatine phosphokinase levels after isolated limb infusion for melanoma: a multi-institutional analysis |
| title_auth |
Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis |
| abstract |
Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. |
| abstractGer |
Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. |
| abstract_unstemmed |
Background Isolated limb infusion (ILI) is a minimally invasive technique delivering regional chemotherapy to treat in-transit extremity melanoma. Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. On the contrary, aIBW was significantly associated with a lower risk of severe toxicity. Perfusate blood gas at 30 min [pH, $ PaO_{2} $, and base excess (BE) ], limb temperature, and ischemia time were not predictive of limb toxicity. On multivariate analysis, severe toxicity was associated with female sex (P = 0.01), papaverine (P = 0.01), and high peak CK levels (P < 0.01). Independent predictors of high CK levels included younger age, unadjusted melphalan dose, and low $ PaO_{2} $ at 30 min. Conclusions ILI can be performed with an acceptable morbidity. Papaverine use, female gender, and high peak CK were associated with higher limb toxicity. CK levels can be diminished significantly with aIBW. |
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9 |
| title_short |
Predictive Factors of Regional Toxicity and Serum Creatine Phosphokinase Levels After Isolated Limb Infusion for Melanoma: A Multi-Institutional Analysis |
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https://dx.doi.org/10.1245/s10434-009-0563-9 |
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Delman, Keith A. Beasley, Georgia M. Mosca, Paul J. Hochwald, Steven N. Grobmyer, Stephen R. Andtbacka, Robert H. Noyes, R. Dirk Kane, John M. Ross, Merrick I. Tyler, Douglas S. Zager, Jonathan S. |
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Delman, Keith A. Beasley, Georgia M. Mosca, Paul J. Hochwald, Steven N. Grobmyer, Stephen R. Andtbacka, Robert H. Noyes, R. Dirk Kane, John M. Ross, Merrick I. Tyler, Douglas S. Zager, Jonathan S. |
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10.1245/s10434-009-0563-9 |
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2024-07-04T03:34:33.530Z |
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1803617905968939008 |
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Determining perioperative factors that could predict toxicity is important to optimize strategies to improve clinical outcomes after regional chemotherapy in melanoma. Methods Perioperative factors from 171 ILI patients performed at eight centers from 2001 to 2008 were reviewed. The Wieberdink limb toxicity scale and creatine phosphokinase (CK) levels were used to measure toxicity. Logistic regression analysis was used to estimate the association between toxicity and perioperative parameters. Results Mild (grades I–II) and severe (grades ≥III) limb toxicity developed in 68% and 32% of patients, respectively. Melphalan adjusted for ideal body weight (aIBW) and papaverine were used in 47% and 63% of patients, respectively. Median peak CK for all patients was 563 U/l, and median peak occurred at postoperative day 4. On univariate analysis, papaverine and high CK levels (>563 U/l) were significantly associated with higher toxicity. 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| score |
7.4002237 |