Liver resection for metastatic melanoma with postoperative tumor-infiltrating lymphocyte therapy.
Liver resection for metastatic melanoma with postoperative tumor-infiltrating lymphocyte therapy.
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DOI：
10.1245/s10434-009-0677-0
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发表时间：
2010-01
影响因子：
3.7
通讯作者：
Avital I
中科院分区：
文献类型：
--
作者：
Ripley RT;Davis JL;Klapper JA;Mathur A;Kammula U;Royal RE;Yang JC;Sherry RM;Hughes MS;Libutti SK;White DE;Steinberg SM;Dudley ME;Rosenberg SA;Avital I
转移性黑色素瘤(MML)患者的中位生存期为4至6个月。这项研究评估了接受肝切除术的患者，这些患者打算在术后接受肿瘤浸润性淋巴细胞(TIL)治疗。对1980-2008年间接受肝切除的MML患者的前瞻性数据库进行了回顾分析。共有539名患者患有MML，其中39%(204/539)的患者收集了肿瘤用于TIL。共有17%(35/204)的患者接受了TIL的肝切除术。3年总生存率为53%。单因素分析显示，无肝外病变(P=.026)、切缘阴性(P=.056)和单发肝转移(P=.04)对生存率有预测作用。经多因素分析，仅缺乏肝外疾病仍是生存的重要预测因素(P=.043)。31%(11/35)的患者接受了无TIL的完全切除，69%(24/35)的患者同时接受了肝内外病变的TIL治疗。对于11名患者中的9名(排除基因治疗的11名患者中的2名)，3年生存率为80%。9例中有4例复发(44%)，中位无瘤生存期为1.2年。对于24例(69%)有残留疾病的患者，3年生存率为51%(排除基因治疗的24例患者中有2例)。共有63%(15/24)的患者接受了TIL治疗(3年生存率65%)，29%(7/24)的患者没有接受TIL治疗。共有40%(6/15)的患者对TIL有部分反应，67%(4/6)的患者在中位随访时间为55个月(范围42-197个月)时没有进展。月)。未接受TIL治疗的7名患者的中位生存期为4.6个月。应该考虑切除合并TIL的MML，因为它可以在高度选择的患者组中延长生存时间。
Patients with metastatic melanoma to the liver (MML) have a median survival of 4 to 6 months. This study evaluated patients who underwent liver resection with intent to receive postoperative tumor-infiltrating lymphocyte (TIL) therapy. Retrospective analysis of a prospective database identified patients with MML who underwent liver resection from 1980 to 2008. A total of 539 patients had MML, and 39% (204 of 539) had tumor collected for TIL. A total of 17% (35 of 204) underwent liver resection for TIL. The 3-year overall survival was 53%. Lack of extrahepatic disease (P = .026), negative margin (P = .056), and single hepatic metastasis (P = .04) predicted survival after univariate analysis. Only lack of extrahepatic disease remained a significant predictor of survival after multivariate analysis (P = .043). A total of 31% (11 of 35) underwent complete resection without TIL, and 69% (24 of 35) underwent resection with synchronous intrahepatic and extrahepatic disease with intent to receive TIL. For 9 of 11 patients (2 of 11 excluded for gene therapy), 3-year survival was 80%. A total of 4 (44%) of 9 experienced recurrence, with a median disease-free survival of 1.2 years. For 24 patients (69%) with residual disease, 3-year survival was 51% (2 of 24 excluded for gene therapy). A total of 63% (15 of 24) received postoperative TIL (3-year survival 65%), and 29% (7 of 24) did not. A total of 40% (6 of 15) had disease that partially responded to TIL; the disease of 67% (4 of 6) had not progressed at median follow-up of 55 months (range, 42–197? months). The seven patients who did not receive TIL had a median survival of 4.6 months. Resection of MML with TIL should be considered because it can result in prolonged survival in a highly selected group of patients.
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影响因子：
45.3
作者：
Chapman, PB;Einhorn, LH;Kirkwood, JM
通讯作者：
Kirkwood, JM
影响因子：
3
作者：
FOSTER, JH
通讯作者：
FOSTER, JH
影响因子：
9
作者：
Rosenberg, SA;Yang, JC;Steinberg, SM
通讯作者：
Steinberg, SM
影响因子：
45.3
作者：
Dudley, ME;Wunderlich, JR;Rosenberg, SA
通讯作者：
Rosenberg, SA
影响因子：
--
作者：
Rose, DM;Essner, R;Morton, DL
通讯作者：
Morton, DL