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. 2013 Aug;23(4):290-7.
doi: 10.1097/CMR.0b013e3283632c83.

Prospective assessment of lymphedema incidence and lymphedema-associated symptoms following lymph node surgery for melanoma

John R Hyngstrom  1 , Yi-Ju Chiang, Kate D Cromwell, Merrick I Ross, Yan Xing, Kristi S Mungovan, Jeffrey E Lee, Jeffrey E Gershenwald, Richard E Royal, Anthony Lucci, Jane M Armer, Janice N Cormier
Affiliations

Prospective assessment of lymphedema incidence and lymphedema-associated symptoms following lymph node surgery for melanoma

John R Hyngstrom et al. Melanoma Res. 2013 Aug.

Abstract

We aimed to prospectively assess limb volume change (LVC) and associated symptoms in patients with melanoma undergoing sentinel lymph node biopsy and/or therapeutic lymph node dissection. Limb volume was measured preoperatively and postoperatively at 6 and 12 months using a perometer (1000 mol/l). LVC was calculated and used to define three groups: less than 5%, 5-10%, and greater than 10%. A 19-item lymphedema symptom questionnaire was administered at baseline, 6, and 12 months. One hundred and eighty-two patients were enrolled. Twelve months after axillary surgery, 9% had LVC 5-10% and 13% had LVC greater than 10%. Twelve months after inguinofemoral surgery, 10% had LVC 5-10% and 13% had LVC greater than 10%. There was a significant seven- to nine-fold increase in symptoms for patients with LVC greater than 10% compared with those with LVC less than 5% (P<0.05). On multivariate analysis, therapeutic lymph node dissection versus sentinel lymph node biopsy (odds ratio=3.18; P<0.01) and borderline significance for lower-extremity versus upper-extremity procedures (odds ratio=1.72; P=0.07) were associated with LVC greater than 5%. LVC greater than 5% is common at 12 months following nodal surgery for melanoma and is associated with symptoms. Informed consent for melanoma patients undergoing lymph node surgery should include a discussion of the risks of postoperative lymphedema.

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Figures

Figure 1
Figure 1
Median symptom assessment scores at baseline (T0), 6 months (T1), and 12 months (T2) stratified by limb volume change expressed as a percentage of the limb volume at baseline (a) and by site of surgery (b).
Figure 1
Figure 1
Median symptom assessment scores at baseline (T0), 6 months (T1), and 12 months (T2) stratified by limb volume change expressed as a percentage of the limb volume at baseline (a) and by site of surgery (b).
Figure 2
Figure 2
Median symptom assessment scores at baseline (T0), 6 months (T1), and 12 months (T2) stratified by site of surgery and type of operation. LE, lower extremity; UE, upper extremity; SLNB, sentinel lymph node biopsy; TLND, therapeutic lymph node dissection
See this image and copyright information in PMC

References

    1. Cormier JN, Askew RL, Mungovan KS, Xing Y, Ross MI, Armer JM. Lymphedema beyond breast cancer: a systematic review and meta-analysis of cancer-related secondary lymphedema. Cancer. 2010;116:5138–5149. - PubMed
    1. de Vries M, Vonkeman WG, van Ginkel RJ, Hoekstra HJ. Morbidity after inguinal sentinel lymph node biopsy and completion lymph node dissection in patients with cutaneous melanoma. Eur J Surg Oncol. 2006;32:785–789. - PubMed
    1. Starritt EC, Joseph D, McKinnon JG, Lo SK, de Wilt JH, Thompson JF. Lymphedema after complete axillary node dissection for melanoma: assessment using a new, objective definition. Ann Surg. 2004;240:866–874. - PMC - PubMed
    1. Wrightson WR, Wong SL, Edwards MJ, Chao C, Reintgen DS, Ross MI, et al. Complications associated with sentinel lymph node biopsy for melanoma. Ann Surg Oncol. 2003;10:676–680. - PubMed
    1. Burmeister BH, Smithers BM, Davis S, Spry N, Johnson C, Krawitz H, Baumann KC. Radiation therapy following nodal surgery for melanoma: an analysis of late toxicity. ANZ J Surg. 2002;72:344–348. - PubMed

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