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.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30214 Obstetrics and gynaecology
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW 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
Tags 14119612, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 28/6/2022 14:14.
Abstract
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.
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