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

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.

Basic information

Original name

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

Authors

BORČINOVÁ, Martina (203 Czech Republic), Volker RAGOSCH, Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Sylva BAJSOVÁ (203 Czech Republic), Radovan PILKA (203 Czech Republic), Ariel GLICKMAN, Sonia GARRIDO-MALLACH, Francesco RASPAGLIESI, Wiktor SZATKOWSKI, Maja PAKIZ, Leon C SNYMAN, Roman KOCIÁN (203 Czech Republic), Karl TAMUSSINO, Vladimír KALIST, Martin MICHAL (203 Czech Republic), Myriam Gracia SEGOVIA, Robert POKA, Barbara KIPP, Grzegorz SZEWCZYK, Dariusz WYDRA, Róbert TÓTH, Alla VINNYTSKA, Daniela FISCHEROVÁ (203 Czech Republic), Kathrin SIEGLER and David CIBULA (203 Czech Republic, guarantor)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30214 Obstetrics and gynaecology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 4.700

RIV identification code

RIV/00216224:14110/22:00126156

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.ygyno.2021.10.089

UT WoS

000739385200012

Keywords in English

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

Abstract

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.

Citovat

BORČINOVÁ, Martina, Volker RAGOSCH, Jiří JARKOVSKÝ, 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 and David CIBULA. Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study. Gynecologic Oncology. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2022, vol. 164, No 1, p. 76-84. ISSN 0090-8258. Available from: https://dx.doi.org/10.1016/j.ygyno.2021.10.089.

@article{1863138,
   author = {Borčinová, Martina and Ragosch, Volker and Jarkovský, Jiří and Bajsová, Sylva and Pilka, Radovan and Glickman, Ariel and GarridoandMallach, Sonia and Raspagliesi, Francesco and Szatkowski, Wiktor and Pakiz, Maja and Snyman, Leon C and Kocián, Roman and Tamussino, Karl and Kalist, Vladimír and Michal, Martin and Segovia, Myriam Gracia and Poka, Robert and Kipp, Barbara and Szewczyk, Grzegorz and Wydra, Dariusz and Tóth, Róbert and Vinnytska, Alla and Fischerová, Daniela and Siegler, Kathrin and Cibula, David},
   article_location = {SAN DIEGO},
   article_number = {1},
   doi = {http://dx.doi.org/10.1016/j.ygyno.2021.10.089},
   keywords = {Lower limb lymphedema; Limb volume change; Transient edema; Assessment standardisation; Cervical cancer},
   language = {eng},
   issn = {0090-8258},
   journal = {Gynecologic Oncology},
   title = {Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study},
   url = {https://www.sciencedirect.com/science/article/pii/S0090825821015304?via%3Dihub},
   volume = {164},
   year = {2022}
}

TY  - JOUR
ID  - 1863138
AU  - Borčinová, Martina - Ragosch, Volker - Jarkovský, Jiří - Bajsová, Sylva - Pilka, Radovan - Glickman, Ariel - Garrido-Mallach, Sonia - Raspagliesi, Francesco - Szatkowski, Wiktor - Pakiz, Maja - Snyman, Leon C - Kocián, Roman - Tamussino, Karl - Kalist, Vladimír - Michal, Martin - Segovia, Myriam Gracia - Poka, Robert - Kipp, Barbara - Szewczyk, Grzegorz - Wydra, Dariusz - Tóth, Róbert - Vinnytska, Alla - Fischerová, Daniela - Siegler, Kathrin - Cibula, David
PY  - 2022
TI  - Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study
JF  - Gynecologic Oncology
VL  - 164
IS  - 1
SP  - 76-84
EP  - 76-84
PB  - ACADEMIC PRESS INC ELSEVIER SCIENCE
SN  - 00908258
KW  - Lower limb lymphedema
KW  - Limb volume change
KW  - Transient edema
KW  - Assessment standardisation
KW  - Cervical cancer
UR  - https://www.sciencedirect.com/science/article/pii/S0090825821015304?via%3Dihub
N2  - 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.
ER  -

BORČINOVÁ, Martina, Volker RAGOSCH, Jiří JARKOVSKÝ, 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 and David CIBULA. Challenges in lower limb lymphoedema assessment based on limb volume change: Lessons learnt from the SENTIX prospective multicentre study. \textit{Gynecologic Oncology}. SAN DIEGO: ACADEMIC PRESS INC ELSEVIER SCIENCE, 2022, vol.~164, No~1, p.~76-84. ISSN~0090-8258. Available from: https://dx.doi.org/10.1016/j.ygyno.2021.10.089.

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