Treatment Strategies and Effectiveness in Lymphatic Malformations: A 10-Year Retrospective Study

Abstract

Recurrence is a major challenge in treatment of lymphatic malformations (LMs) world-wide. The objectives of the current study were to investigate risk factors associated with LM recurrence and to compare effectiveness of surgical and endovascular treatments. A multi-center 10-year retrospective chart review was conducted on all consecutive patients treated for LMs from 2009 to 2019. Data collected included post-treatment size, symptoms, and recurrence. Stepwise multiple regression analysis was used to identify risk factors and to compare treatment modalities. A total of 13 patients with 20 treatment cases were included. No significant difference was observed in size reduction and symptom alleviation between the treatment groups. Resection showed the highest recurrence rate of 36.4% (p=0.04) and lymphaticovenular anastomosis (LVA) presented excel-lent results in post-treatment size, symptoms, and recurrence despite lack of statistical significance. Microcystic type of LMs was identified as an independent risk factor for recurrence. Both surgery and sclerotherapy are effective in improving size and symptoms of LMs. This data will help physicians and patients choose the optimal treatment and potentially predict progression.

Keywords: Lymphatic malformations; Lymphatic-venous anastomosis; Macrocystic; Microcystic; Recurrence.