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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2010

01-01-2010 | Hepatobiliary Tumors

Liver Resection for Metastatic Melanoma with Postoperative Tumor-Infiltrating Lymphocyte Therapy

Authors: R. Taylor Ripley, MD, Jeremy L. Davis, MD, Jacob A. Klapper, MD, Aarti Mathur, MD, Udai Kammula, MD, Richard E. Royal, MD, James C. Yang, MD, Richard M. Sherry, MD, Marybeth S. Hughes, MD, Steven K. Libutti, MD, Donald E. White, MS, Seth M. Steinberg, PhD, Mark E. Dudley, PhD, Steven A. Rosenberg, MD, PhD, Itzhak Avital, MD

Published in: Annals of Surgical Oncology | Issue 1/2010

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Abstract

Background

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.

Methods

Retrospective analysis of a prospective database identified patients with MML who underwent liver resection from 1980 to 2008.

Results

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.

Conclusions

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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Metadata
Title
Liver Resection for Metastatic Melanoma with Postoperative Tumor-Infiltrating Lymphocyte Therapy
Authors
R. Taylor Ripley, MD
Jeremy L. Davis, MD
Jacob A. Klapper, MD
Aarti Mathur, MD
Udai Kammula, MD
Richard E. Royal, MD
James C. Yang, MD
Richard M. Sherry, MD
Marybeth S. Hughes, MD
Steven K. Libutti, MD
Donald E. White, MS
Seth M. Steinberg, PhD
Mark E. Dudley, PhD
Steven A. Rosenberg, MD, PhD
Itzhak Avital, MD
Publication date
01-01-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 1/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0677-0

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