Liver resection for metastatic melanoma with postoperative tumor-infiltrating lymphocyte therapy

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)163-170
Number of pages8
JournalAnnals of Surgical Oncology
Volume17
Issue number1
DOIs
StatePublished - Jan 1 2010

ASJC Scopus subject areas

  • Surgery
  • Oncology

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