Abstract
Isolated limb perfusion for unresectable extremity cutaneous squamous cell carcinoma; an effective limb saving strategy
Highlights
Non-melanoma skin cancer (NMSC) is the most frequent human malignancy[1,2] with an increasing incidence reaching epidemic proportions among Caucasians in Europe, America and Australia.[3,4,5,6,7,8] Approximately 80% of all NMSC are basal cell carcinomas (BCC) and 20% are cutaneous squamous cell carcinomas.[6,7,8,9]Usually cutaneous Squamous Cell Carcinoma (cSCC) presents as a localised lesion, for which various treatment strategies are available: wide surgical excision, Mohs surgery, cryosurgery, and radiation therapy
This study aims to evaluate the effectiveness of TM-ILP as a limb saving strategy for locally advanced cSCCs in the extremities
The patient died two months after TM-ILP of septic complications caused by an infected vascular prosthesis. This unique multicentre experience of 30 TM-ILPs as treatment for locally advanced cSCC and demonstrates that TM-ILP is a valuable limb saving strategy in selected patients who would otherwise need an amputation or function disrupting ablative surgery. This is the largest report on the outcome of ILP for locally advanced cSCC
Summary
Non-melanoma skin cancer (NMSC) is the most frequent human malignancy[1,2] with an increasing incidence reaching epidemic proportions among Caucasians in Europe, America and Australia.[3,4,5,6,7,8] Approximately 80% of all NMSC are basal cell carcinomas (BCC) and 20% are cutaneous squamous cell carcinomas (cSCC).[6,7,8,9]Usually cSCC presents as a localised lesion, for which various treatment strategies are available: wide surgical excision, Mohs surgery, cryosurgery, and radiation therapy. Some patients will present with locally advanced disease. 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. 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
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