Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer
Identifieur interne : 000F98 ( Main/Exploration ); précédent : 000F97; suivant : 000F99Identification of Prognostic Risk Factors for Transient and Persistent Lymphedema after Multimodal Treatment for Breast Cancer
Auteurs : Myungsoo Kim [Corée du Sud] ; Kyung Hwan Shin [Corée du Sud] ; So-Youn Jung [Corée du Sud] ; Seeyoun Lee [Corée du Sud] ; Han-Sung Kang [Corée du Sud] ; Eun Sook Lee [Corée du Sud] ; Seung Hyun Chung [Corée du Sud] ; Yeon-Joo Kim [Corée du Sud] ; Tae Hyun Kim [Corée du Sud] ; Kwan Ho Cho [Corée du Sud]Source :
- Cancer Research and Treatment : Official Journal of Korean Cancer Association [ 1598-2998 ] ; 2016.
Abstract
The purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer.
A total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next follow-up; arm swelling that persisted over two consecutive examinations was considered PLE.
At a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors).
One-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.
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DOI: 10.4143/crt.2015.463
PubMed: 26875199
PubMed Central: 5080824
Affiliations:
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sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-463">Department of Radiation Oncology, Seoul National University College of Medicine, Seoul,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jung, So Youn" sort="Jung, So Youn" uniqKey="Jung S" first="So-Youn" last="Jung">So-Youn Jung</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Seeyoun" sort="Lee, Seeyoun" uniqKey="Lee S" first="Seeyoun" last="Lee">Seeyoun Lee</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kang, Han Sung" sort="Kang, Han Sung" uniqKey="Kang H" first="Han-Sung" last="Kang">Han-Sung Kang</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" 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National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Tae Hyun" sort="Kim, Tae Hyun" uniqKey="Kim T" first="Tae Hyun" last="Kim">Tae Hyun Kim</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country 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last="Kim">Myungsoo Kim</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-crt-2015-463">Department of Radiation Oncology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Shin, Kyung Hwan" sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-crt-2015-463">Department of Radiation Oncology, Seoul National University College of Medicine, Seoul,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jung, So Youn" sort="Jung, So Youn" uniqKey="Jung S" first="So-Youn" last="Jung">So-Youn Jung</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Seeyoun" sort="Lee, Seeyoun" uniqKey="Lee S" first="Seeyoun" last="Lee">Seeyoun Lee</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kang, Han Sung" sort="Kang, Han Sung" uniqKey="Kang H" first="Han-Sung" last="Kang">Han-Sung Kang</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun Sook" last="Lee">Eun Sook Lee</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chung, Seung Hyun" sort="Chung, Seung Hyun" uniqKey="Chung S" first="Seung Hyun" last="Chung">Seung Hyun Chung</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Yeon Joo" sort="Kim, Yeon Joo" uniqKey="Kim Y" first="Yeon-Joo" last="Kim">Yeon-Joo Kim</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Tae Hyun" sort="Kim, Tae Hyun" uniqKey="Kim T" first="Tae Hyun" last="Kim">Tae Hyun Kim</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><affiliation wicri:level="1"><nlm:aff id="af1-crt-2015-463">Research Institute and Hospital, National Cancer Center, Goyang,<country>Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Cancer Research and Treatment : Official Journal of Korean Cancer Association</title><idno type="ISSN">1598-2998</idno><idno type="eISSN">2005-9256</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>The purpose of this study is to identify risk factors for transient lymphedema (TLE) and persistent lymphedema (PLE) following treatment for breast cancer.</p></sec><sec><title>Materials and Methods</title><p>A total of 1,073 patients who underwent curative breast surgery were analyzed. TLE was defined as one episode of arm swelling that had resolved spontaneously by the next follow-up; arm swelling that persisted over two consecutive examinations was considered PLE.</p></sec><sec><title>Results</title><p>At a median follow-up period of 5.1 years, 370 cases of lymphedema were reported, including 120 TLE (11.2%) and 250 PLE (23.3%). Initial grade 1 swelling was observed in 351 patients, of which 120 were limited to TLE (34%), while the other 231 progressed to PLE (66%). All initial swelling observed in TLE patients was classified as grade 1. In multivariate analysis, chemotherapy with taxane and supraclavicular radiation therapy (SCRT) were associated with development of TLE, whereas SCRT, stage III cancer and chemotherapy with taxane were identified as risk factors for PLE (p < 0.05). The estimated incidence of TLE among initial grade 1 patients was calculated using up to three treatment-related risk factors (number of dissected axillary lymph nodes, SCRT, and taxane chemotherapy). The approximate ratios of TLE and PLE based on the number of risk factors were 7:1 (no factor), 1:1 (one factor), 1:2 (two factors), and 1:3 (three factors).</p></sec><sec><title>Conclusion</title><p>One-third of initial swelling events were transient, whereas the other two-thirds of patients experienced PLE. Estimation of TLE and PLE based on known treatment factors could facilitate prediction of this life-long complication.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Disipio, T" uniqKey="Disipio T">T DiSipio</name></author><author><name sortKey="Rye, S" uniqKey="Rye S">S Rye</name></author><author><name sortKey="Newman, B" uniqKey="Newman B">B Newman</name></author><author><name sortKey="Hayes, S" uniqKey="Hayes S">S Hayes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cemal, Y" uniqKey="Cemal Y">Y Cemal</name></author><author><name sortKey="Pusic, A" uniqKey="Pusic A">A Pusic</name></author><author><name sortKey="Mehrara, Bj" uniqKey="Mehrara B">BJ Mehrara</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, M" uniqKey="Kim M">M Kim</name></author><author><name sortKey="Kim, Sw" uniqKey="Kim S">SW Kim</name></author><author><name sortKey="Lee, Su" 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uniqKey="Cheville A">A Cheville</name></author><author><name sortKey="Solin, Lj" uniqKey="Solin L">LJ Solin</name></author><author><name sortKey="Dutta, P" uniqKey="Dutta P">P Dutta</name></author><author><name sortKey="Both, S" uniqKey="Both S">S Both</name></author><author><name sortKey="Harris, Ee" uniqKey="Harris E">EE Harris</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Corée du Sud</li></country></list><tree><country name="Corée du Sud"><noRegion><name sortKey="Kim, Myungsoo" sort="Kim, Myungsoo" uniqKey="Kim M" first="Myungsoo" last="Kim">Myungsoo Kim</name></noRegion><name sortKey="Cho, Kwan Ho" sort="Cho, Kwan Ho" uniqKey="Cho K" first="Kwan Ho" last="Cho">Kwan Ho Cho</name><name sortKey="Chung, Seung Hyun" sort="Chung, Seung Hyun" uniqKey="Chung S" first="Seung Hyun" last="Chung">Seung Hyun Chung</name><name sortKey="Jung, So Youn" sort="Jung, So Youn" uniqKey="Jung S" first="So-Youn" last="Jung">So-Youn Jung</name><name sortKey="Kang, Han Sung" sort="Kang, Han Sung" uniqKey="Kang H" first="Han-Sung" last="Kang">Han-Sung Kang</name><name sortKey="Kim, Myungsoo" sort="Kim, Myungsoo" uniqKey="Kim M" first="Myungsoo" last="Kim">Myungsoo Kim</name><name sortKey="Kim, Tae Hyun" sort="Kim, Tae Hyun" uniqKey="Kim T" first="Tae Hyun" last="Kim">Tae Hyun Kim</name><name sortKey="Kim, Yeon Joo" sort="Kim, Yeon Joo" uniqKey="Kim Y" first="Yeon-Joo" last="Kim">Yeon-Joo Kim</name><name sortKey="Lee, Eun Sook" sort="Lee, Eun Sook" uniqKey="Lee E" first="Eun Sook" last="Lee">Eun Sook Lee</name><name sortKey="Lee, Seeyoun" sort="Lee, Seeyoun" uniqKey="Lee S" first="Seeyoun" last="Lee">Seeyoun Lee</name><name sortKey="Shin, Kyung Hwan" sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name><name sortKey="Shin, Kyung Hwan" sort="Shin, Kyung Hwan" uniqKey="Shin K" first="Kyung Hwan" last="Shin">Kyung Hwan Shin</name></country></tree></affiliations></record>Pour 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