Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
J Surg Oncol. 2019 Sep;120(3):540-549. doi: 10.1002/jso.25600. Epub 2019 Jul 2.
Isolated limb perfusion (ILP) and infusion (ILI) are treatment modalities for unresectable melanoma in-transit metastases and extremity soft tissue sarcomas (STS). We sought to characterize the national trend in their utilization in the context of novel melanoma therapies introduced in 2011.
Using the National Inpatient Sample (2005-2014), patients with a primary diagnosis of limb melanoma or STS who underwent ILP/ILI were identified by diagnosis and procedure codes. Annual percent change (APC) in ILP/ILI procedures was determined.
From 2005 through 2014, 670 and 130 ILP/ILI procedures were performed for melanoma and STS, respectively. Mean age was 64 (SD 15) years for melanoma and 59 (SD 18) years for STS. Over time, procedures for melanoma decreased with an APC of -17 (P = .019). Comparing 2005-2010 and 2011-2014, the mean number of procedures for melanoma decreased from 91 to 32 per year (P = .007). In contrast, there was no change for STS (APC 6.5, P = .39; mean 11 and 16 per year in 2005-2010 and 2011-2014, respectively, P = .46).
ILI/ILP utilization has decreased for melanoma, but not for STS. Whether trends for ILP and ILI differed could not be determined. ILP/ILI remains an important option to consider for regional disease control.
孤立肢体灌注（ILP）和输注（ILI）是治疗不可切除的黑色素瘤转移和四肢软组织肉瘤（STS）的方法。我们旨在探讨在 2011 年引入新的黑色素瘤治疗方法的背景下，这些治疗方法的应用趋势。
使用国家住院患者样本（2005-2014 年），通过诊断和程序代码确定接受 ILP/ILI 的肢体黑色素瘤或 STS 患者。确定 ILP/ILI 手术的年百分比变化（APC）。
2005 年至 2014 年，黑色素瘤和 STS 分别进行了 670 次和 130 次 ILP/ILI 手术。黑色素瘤的平均年龄为 64 岁（SD 15），STS 为 59 岁（SD 18）。随着时间的推移，黑色素瘤的手术呈 APC-17（P=0.019）减少趋势。比较 2005-2010 年和 2011-2014 年，黑色素瘤的手术数量从每年 91 例减少至 32 例（P=0.007）。相比之下，STS 没有变化（APC 6.5，P=0.39；2005-2010 年和 2011-2014 年的平均手术例数分别为每年 11 例和 16 例，P=0.46）。
ILI/ILP 的应用在黑色素瘤中减少，但在 STS 中没有减少。是否存在 ILP 和 ILI 的不同趋势尚无法确定。ILP/ILI 仍然是控制区域性疾病的重要选择。
