Outcomes of older adults aged 90 and over with cutaneous malignancies after electrochemotherapy with bleomycin: A matched cohort analysis from the InspECT registry
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Outcomes of older adults aged 90 and over with cutaneous malignancies after electrochemotherapy with bleomycin : A matched cohort analysis from the InspECT registry. / Sersa, Gregor; Mascherini, Matteo; Di Prata, Claudia; Odili, Joy; de Terlizzi, Francesca; McKenzie, Gordon A.G.; Clover, A. James P.; Bertino, Giulia; Spina, Romina; Groselj, Ales; Cappellesso, Rocco; Gehl, Julie; Bisase, Brian; Curatolo, Pietro; Kis, Erika; Lico, Valbona; Muir, Tobian; Orlando, Antonio; Quaglino, Pietro; Matteucci, Paolo; Valpione, Sara; Campana, Luca G.
I: European Journal of Surgical Oncology, Bind 47, Nr. 4, 2021, s. 902-912.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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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.
PY - 2021
Y1 - 2021
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 - Journal article
C2 - 33183930
AN - SCOPUS:85095856274
VL - 47
SP - 902
EP - 912
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 4
ER -
ID: 253139093