TY - JOUR
T1 - Outcomes of older adults aged 90 and over with cutaneous malignancies after electrochemotherapy with bleomycin
T2 - A matched cohort analysis from the InspECT registry
AU - Sersa, Gregor
AU - Mascherini, Matteo
AU - Di Prata, Claudia
AU - Odili, Joy
AU - de Terlizzi, Francesca
AU - McKenzie, Gordon A.G.
AU - Clover, A. James P.
AU - Bertino, Giulia
AU - Spina, Romina
AU - Groselj, Ales
AU - Cappellesso, Rocco
AU - Gehl, Julie
AU - Bisase, Brian
AU - Curatolo, Pietro
AU - Kis, Erika
AU - Lico, Valbona
AU - Muir, Tobian
AU - Orlando, Antonio
AU - Quaglino, Pietro
AU - Matteucci, Paolo
AU - Valpione, Sara
AU - Campana, Luca G.
N1 - Funding Information:
We are deeply grateful to the patients and their families, and the nursing staffs of the participating centers. This work was supported by the Slovenian Research Agency (ARRS) , grant No. P3-0003 and J39269 . We thank Andrea Simioni for patient care, data check, and manuscript editing; Simona Sola for providing tissue slides; Susanna Careri, Cesare Massone and Rowan Pritchard-Jones for patient care; Michela Batista for assisting with the literature search. During the preparation of this manuscript, the authors printed out 0/64 papers included in the reference list, in compliance with the Sustainable Paperless Reference Initiative Nourishes Trees (SPRINT) recommendation (SPRINT score: 0%) ( https://t.co/SStD2ZeGNN ).
Publisher Copyright:
© 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2021/4/1
Y1 - 2021/4/1
N2 - BACKGROUND: With extending life expectancy, more people are diagnosed with cutaneous malignancies at advanced ages and are offered nonsurgical treatment. We assessed outcomes of the oldest-old adults after electrochemotherapy (ECT).METHODS: The International Network for Sharing Practices of ECT (InspECT) registry was queried for adults aged ≥90 years (ys) with skin cancers/cutaneous metastases of any histotype who underwent bleomycin-ECT (2006-2019). These were subanalysed with patients aged <90 ys after matching 1:2 for tumor location, number, size, histotype, and previous treatments. We assessed ECT modalities, toxicity (CTCAE), response (RECIST), and patient perception (EQ-5D).RESULTS: Sixty-one patients represented the study cohort (median 92 ys, range 92-104), 122 the control group (median 77 ys, range 23-89). Among the oldest-old, 44 patients (72%) had primary/recurrent skin cancers, 17 (28%) cutaneous metastases. Median tumour size was 15 mm (range, 5-450). The oldest-old adults underwent ECT mainly under local/regional anaesthesia (59% vs 39% p = .012). We observed no differences regarding dose and route of chemotherapy (intravenous vs intratumoral, p = .308), electrode geometry (linear vs hexagonal, p = .172) and procedural duration (18 vs 21 min, p = .378). Complete response (57.4 [95%-CI 44.1%-70.0%] vs 64.7% [95%-CI 55.6%-73.2%], p = .222) and 1-year local control (76.7% vs 81.7, p = .092) rates were comparable. Pain and skin hyperpigmentation were mild in both groups. Skin ulceration persisted longer in the oldest-old patients (4.4 vs 2.4 months, p = .008).CONCLUSIONS: The oldest-old adults with cutaneous malignancies undergo ECT most commonly under local/regional anaesthesia with safety profiles and clinical effectiveness similar to their younger counterparts, except in case of ulcerated tumors.
AB - BACKGROUND: With extending life expectancy, more people are diagnosed with cutaneous malignancies at advanced ages and are offered nonsurgical treatment. We assessed outcomes of the oldest-old adults after electrochemotherapy (ECT).METHODS: The International Network for Sharing Practices of ECT (InspECT) registry was queried for adults aged ≥90 years (ys) with skin cancers/cutaneous metastases of any histotype who underwent bleomycin-ECT (2006-2019). These were subanalysed with patients aged <90 ys after matching 1:2 for tumor location, number, size, histotype, and previous treatments. We assessed ECT modalities, toxicity (CTCAE), response (RECIST), and patient perception (EQ-5D).RESULTS: Sixty-one patients represented the study cohort (median 92 ys, range 92-104), 122 the control group (median 77 ys, range 23-89). Among the oldest-old, 44 patients (72%) had primary/recurrent skin cancers, 17 (28%) cutaneous metastases. Median tumour size was 15 mm (range, 5-450). The oldest-old adults underwent ECT mainly under local/regional anaesthesia (59% vs 39% p = .012). We observed no differences regarding dose and route of chemotherapy (intravenous vs intratumoral, p = .308), electrode geometry (linear vs hexagonal, p = .172) and procedural duration (18 vs 21 min, p = .378). Complete response (57.4 [95%-CI 44.1%-70.0%] vs 64.7% [95%-CI 55.6%-73.2%], p = .222) and 1-year local control (76.7% vs 81.7, p = .092) rates were comparable. Pain and skin hyperpigmentation were mild in both groups. Skin ulceration persisted longer in the oldest-old patients (4.4 vs 2.4 months, p = .008).CONCLUSIONS: The oldest-old adults with cutaneous malignancies undergo ECT most commonly under local/regional anaesthesia with safety profiles and clinical effectiveness similar to their younger counterparts, except in case of ulcerated tumors.
KW - Bleomycin
KW - Electrochemotherapy
KW - Oldest-old adults with cancer
KW - Skin cancer
KW - Skin-directed therapies
KW - Wound healing
U2 - 10.1016/j.ejso.2020.10.037
DO - 10.1016/j.ejso.2020.10.037
M3 - Article
C2 - 33183930
AN - SCOPUS:85095856274
SN - 0748-7983
VL - 47
SP - 902
EP - 912
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 4
ER -
