J 2022

Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study

BORČINOVÁ, Martina; Volker RAGOSCH; Jiří JARKOVSKÝ; Sylva BAJSOVÁ; Radovan PILKA et al.

Základní údaje

Originální název

Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study

Autoři

BORČINOVÁ, Martina; Volker RAGOSCH; Jiří JARKOVSKÝ ORCID; Sylva BAJSOVÁ; Radovan PILKA; Ariel GLICKMAN; Sonia GARRIDO-MALLACH; Francesco RASPAGLIESI; Wiktor SZATKOWSKI; Maja PAKIZ; Leon C SNYMAN; Roman KOCIÁN; Karl TAMUSSINO; Vladimír KALIST; Martin MICHAL; Myriam Gracia SEGOVIA; Robert POKA; Barbara KIPP; Grzegorz SZEWCZYK; Dariusz WYDRA; Róbert TÓTH; Alla VINNYTSKA; Daniela FISCHEROVÁ; Kathrin SIEGLER a David CIBULA

Vydání

Gynecologic Oncology, SAN DIEGO, ACADEMIC PRESS INC ELSEVIER SCIENCE, 2022, 0090-8258

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30214 Obstetrics and gynaecology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 4.700

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/22:00126156

Organizační jednotka

Lékařská fakulta

EID Scopus

Klíčová slova anglicky

Lower limb lymphedema; Limb volume change; Transient edema; Assessment standardisation; Cervical cancer

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 28. 6. 2022 14:14, Mgr. Tereza Miškechová

Anotace

V originále

Background. Lower limb lymphoedema (LLL) is the most disabling adverse effect of surgical staging of pelvic lymph nodes. However, the lack of standardisation of volumetric LLL assessment hinders direct comparison between the studies and makes LLL reporting unreliable. The aim of our study is to report outcomes from a prospective trial that have implications for LLL assessment standardisation. Methods. In the prospective international multicentre trial SENTIX, a group of 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral sentinel lymph node biopsy was prospectively evaluated by objective LLL assessment, based on limb volume change (LVC) using circumferrential limb measurements and subjective patient-reported swelling. The assessments were conducted in six-month periods over 24 months post-surgery. Results. Patient LVC substantially fluctuated in both positive and negative directions, which were comparable in frequency up to +/- 14% change. Thirty-eight patients experienced persistent LVC increase >10% classified as LLL, with nine months median time to onset. Some 34.2% of cases experienced onset later than one year after the surgery. Thirty-three patients (22%) experienced transient oedema characterised as LVC >10%, which resolved without intervention between two consequent follow-up visits. No significant correlation between LVC >10% and a patient-reported swelling was observed. Conclusions. Given that we observed comparable fluctuations of the the lower-limb volumes after surgical treatment of cervical cancer in both positive and negative direction up to +/- 14%, the diagnostic threshold for LLL diagnosis based on LVC should be increased to >15% LVC. The distinction of transient oedema from persistent LLL requires repeated measurements. Also, as one-third of LLL cases are diagnosed >1-year post-surgery, a sufficient follow-up duration needs to be ensured. Patient-reported swelling correlated poorly with LVC and should only be used as an adjunct to objective LLL assessment.