Treatment of Lymphedema in Patients With Advanced Cancer Receiving Palliative Care: A Single-Center Experience

Abstract

Background: Lymphedema can develop during the progression of neoplastic diseases and is a devastating complication in patients with cancer receiving palliative care. This study aimed to investigate the course of treatment for lymphedema in patients receiving palliative care to assess posttreatment outcomes.

Methods: This single-center, retrospective cohort study reviewed the maintained database of patients with lymphedema who presented to our department from January 2015 through December 2022. A combination of skin care, compression therapy, and lymphaticovenular anastomosis was used to treat lymphedema in patients with cancer receiving palliative care. The upper or lower extremity lymphedema indices, calculated based on 5 upper or 4 lower extremity circumferences and body mass index, were compared at the first and last visits.

Results: Of the 202 patients with lymphedema, 38 patients with 45 affected limbs (upper extremities: 11 patients, 12 limbs; lower extremities: 27 patients, 33 limbs) were included in the analysis. There were no significant changes in edema based on the upper or lower extremity lymphedema indices in the upper (P = .931) or lower extremities (P = .767) between the first and last visits. No pain relief was observed after the treatment. In the treatment differences, the rate of change in edema was -3.6 ± 10.8% for the compression garment and +5.7 ± 11.5% for the lymphaticovenular anastomosis, showing no significant difference (P = .157).

Conclusions: All treatments had limited therapeutic effects, such as reduced edema and pain relief, and there were no significant differences between them.

Keywords: Advanced Cancer; Compression Therapy; Lower Extremity Lymphedema; Lymphaticovenular Anastomosis; Palliative Care; Upper Extremity Lymphedema.

Figure 1

Flowchart of eligible patients. UEL, upper extremity lymphedema; LEL, lower extremity lymphedema.

Figure 2

Changes over time in the UEL or LEL index. *Predicted from medical records. LEL, lower extremity lymphedema; NS, not significant; UEL, upper extremity lymphedema.