The Long-term Risk of Upper-extremity Lymphedema is Two-fold Higher in Breast Cancer Patients than in Melanoma Patients
Identifieur interne : 001746 ( Main/Exploration ); précédent : 001745; suivant : 001747The Long-term Risk of Upper-extremity Lymphedema is Two-fold Higher in Breast Cancer Patients than in Melanoma Patients
Auteurs : Rachel K. Voss [États-Unis] ; Kate D. Cromwell [États-Unis] ; Yi-Ju Chiang [États-Unis] ; Jane M. Armer [États-Unis] ; Merrick I. Ross [États-Unis] ; Jeffrey E. Lee [États-Unis] ; Jeffrey E. Gershenwald [États-Unis] ; Bob R. Stewart [États-Unis] ; Simona F. Shaitelman [États-Unis] ; Janice N. Cormier [États-Unis]Source :
- Journal of surgical oncology [ 0022-4790 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Aisselle, Biopsie de noeud lymphatique sentinelle, Bras, Facteurs de risque, Femelle, Humains, Incidence, Indice de masse corporelle, Lymphoedème (anatomopathologie), Lymphoedème (épidémiologie), Mastectomie, Mâle, Mélanome (), Mélanome (anatomopathologie), Sujet âgé, Tumeurs cutanées (), Tumeurs cutanées (anatomopathologie), Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Études de cohortes.
- MESH :
- anatomopathologie : Lymphoedème, Mélanome, Tumeurs cutanées, Tumeurs du sein.
- épidémiologie : Lymphoedème.
- Adulte d'âge moyen, Aisselle, Biopsie de noeud lymphatique sentinelle, Bras, Facteurs de risque, Femelle, Humains, Incidence, Indice de masse corporelle, Mastectomie, Mâle, Mélanome, Sujet âgé, Tumeurs cutanées, Tumeurs du sein, Études de cohortes.
English descriptors
- KwdEn :
- Aged, Arm, Axilla, Body Mass Index, Breast Neoplasms (pathology), Breast Neoplasms (surgery), Cohort Studies, Female, Humans, Incidence, Lymphedema (epidemiology), Lymphedema (pathology), Male, Mastectomy, Melanoma (pathology), Melanoma (surgery), Middle Aged, Risk Factors, Sentinel Lymph Node Biopsy, Skin Neoplasms (pathology), Skin Neoplasms (surgery).
- MESH :
- epidemiology : Lymphedema.
- pathology : Breast Neoplasms, Lymphedema, Melanoma, Skin Neoplasms.
- surgery : Breast Neoplasms, Melanoma, Skin Neoplasms.
- Aged, Arm, Axilla, Body Mass Index, Cohort Studies, Female, Humans, Incidence, Male, Mastectomy, Middle Aged, Risk Factors, Sentinel Lymph Node Biopsy.
Abstract
We assessed the cumulative incidence, symptoms, and risk factors for upper-extremity lymphedema in breast cancer and melanoma patients undergoing sentinel lymph node biopsy or axillary lymph node dissection.
Patients were recruited preoperatively (time 0) and assessed at 6, 12, and 18 months postoperatively. Limb volume change (LVC) was measured by perometry. Lymphedema was categorized as none, mild (LVC 5–9.9%), or moderate/severe (LVC≥10%). Symptoms were assessed with a validated lymphedema instrument. Longitudinal logistic regression analyses were conducted to identify risk factors associated with moderate/severe lymphedema.
Among 205 breast cancer and 144 melanoma patients, the cumulative incidence of moderate/severe lymphedema at 18 months was 36.5% and 35.0, respectively. However, in adjusted analyses, factors associated with moderate/severe lymphedema were breast cancer (OR 2.0, p=0.03), body mass index ≥30 kg/m2 (OR 1.6, p=0.04), greater number of lymph nodes removed (OR 1.05, p<0.01), and longer interval since surgery (OR 2.33 at 18 months, p<0.01). Conclusions: Lymphedema incidence increased over time in both cohorts. However, the adjusted risk of moderate/severe lymphedema was two-fold higher in breast cancer patients. These results may be attributed to surgical treatment of the primary tumor in the breast and more frequent use of radiation.
Url:
DOI: 10.1002/jso.24068
PubMed: 26477877
PubMed Central: 4715673
Affiliations:
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Voss</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Cromwell, Kate D" sort="Cromwell, Kate D" uniqKey="Cromwell K" first="Kate D." last="Cromwell">Kate D. Cromwell</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Chiang, Yi Ju" sort="Chiang, Yi Ju" uniqKey="Chiang Y" first="Yi-Ju" last="Chiang">Yi-Ju Chiang</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Armer, Jane M" sort="Armer, Jane M" uniqKey="Armer J" first="Jane M." last="Armer">Jane M. Armer</name><affiliation wicri:level="2"><nlm:aff id="A2">The University of Missouri, Sinclair School of Nursing, Columbia, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>The University of Missouri, Sinclair School of Nursing, Columbia</wicri:cityArea></affiliation></author><author><name sortKey="Ross, Merrick I" sort="Ross, Merrick I" uniqKey="Ross M" first="Merrick I." last="Ross">Merrick I. Ross</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Lee, Jeffrey E" sort="Lee, Jeffrey E" uniqKey="Lee J" first="Jeffrey E." last="Lee">Jeffrey E. Lee</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Gershenwald, Jeffrey E" sort="Gershenwald, Jeffrey E" uniqKey="Gershenwald J" first="Jeffrey E." last="Gershenwald">Jeffrey E. Gershenwald</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Stewart, Bob R" sort="Stewart, Bob R" uniqKey="Stewart B" first="Bob R." last="Stewart">Bob R. Stewart</name><affiliation wicri:level="2"><nlm:aff id="A2">The University of Missouri, Sinclair School of Nursing, Columbia, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>The University of Missouri, Sinclair School of Nursing, Columbia</wicri:cityArea></affiliation></author><author><name sortKey="Shaitelman, Simona F" sort="Shaitelman, Simona F" uniqKey="Shaitelman S" first="Simona F." last="Shaitelman">Simona F. Shaitelman</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N." last="Cormier">Janice N. Cormier</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author></analytic><series><title level="j">Journal of surgical oncology</title><idno type="ISSN">0022-4790</idno><idno type="eISSN">1096-9098</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Arm</term><term>Axilla</term><term>Body Mass Index</term><term>Breast Neoplasms (pathology)</term><term>Breast Neoplasms (surgery)</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (pathology)</term><term>Male</term><term>Mastectomy</term><term>Melanoma (pathology)</term><term>Melanoma (surgery)</term><term>Middle Aged</term><term>Risk Factors</term><term>Sentinel Lymph Node Biopsy</term><term>Skin Neoplasms (pathology)</term><term>Skin Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Bras</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Indice de masse corporelle</term><term>Lymphoedème (anatomopathologie)</term><term>Lymphoedème (épidémiologie)</term><term>Mastectomie</term><term>Mâle</term><term>Mélanome ()</term><term>Mélanome (anatomopathologie)</term><term>Sujet âgé</term><term>Tumeurs cutanées ()</term><term>Tumeurs cutanées (anatomopathologie)</term><term>Tumeurs du sein ()</term><term>Tumeurs du sein (anatomopathologie)</term><term>Études de cohortes</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Lymphoedème</term><term>Mélanome</term><term>Tumeurs cutanées</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term><term>Lymphedema</term><term>Melanoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Breast Neoplasms</term><term>Melanoma</term><term>Skin Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Arm</term><term>Axilla</term><term>Body Mass Index</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Mastectomy</term><term>Middle Aged</term><term>Risk Factors</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle</term><term>Bras</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Indice de masse corporelle</term><term>Mastectomie</term><term>Mâle</term><term>Mélanome</term><term>Sujet âgé</term><term>Tumeurs cutanées</term><term>Tumeurs du sein</term><term>Études de cohortes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background and Objectives</title><p id="P1">We assessed the cumulative incidence, symptoms, and risk factors for upper-extremity lymphedema in breast cancer and melanoma patients undergoing sentinel lymph node biopsy or axillary lymph node dissection.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Patients were recruited preoperatively (time 0) and assessed at 6, 12, and 18 months postoperatively. Limb volume change (LVC) was measured by perometry. Lymphedema was categorized as none, mild (LVC 5–9.9%), or moderate/severe (LVC≥10%). Symptoms were assessed with a validated lymphedema instrument. Longitudinal logistic regression analyses were conducted to identify risk factors associated with moderate/severe lymphedema.</p></sec><sec id="S3"><title>Results</title><p id="P3">Among 205 breast cancer and 144 melanoma patients, the cumulative incidence of moderate/severe lymphedema at 18 months was 36.5% and 35.0, respectively. However, in adjusted analyses, factors associated with moderate/severe lymphedema were breast cancer (OR 2.0, p=0.03), body mass index ≥30 kg/m<sup>2</sup> (OR 1.6, p=0.04), greater number of lymph nodes removed (OR 1.05, p<0.01), and longer interval since surgery (OR 2.33 at 18 months, p<0.01). Conclusions: Lymphedema incidence increased over time in both cohorts. However, the adjusted risk of moderate/severe lymphedema was two-fold higher in breast cancer patients. These results may be attributed to surgical treatment of the primary tumor in the breast and more frequent use of radiation.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Missouri (État)</li><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Voss, Rachel K" sort="Voss, Rachel K" uniqKey="Voss R" first="Rachel K." last="Voss">Rachel K. Voss</name></region><name sortKey="Armer, Jane M" sort="Armer, Jane M" uniqKey="Armer J" first="Jane M." last="Armer">Jane M. Armer</name><name sortKey="Chiang, Yi Ju" sort="Chiang, Yi Ju" uniqKey="Chiang Y" first="Yi-Ju" last="Chiang">Yi-Ju Chiang</name><name sortKey="Cormier, Janice N" sort="Cormier, Janice N" uniqKey="Cormier J" first="Janice N." last="Cormier">Janice N. Cormier</name><name sortKey="Cromwell, Kate D" sort="Cromwell, Kate D" uniqKey="Cromwell K" first="Kate D." last="Cromwell">Kate D. Cromwell</name><name sortKey="Gershenwald, Jeffrey E" sort="Gershenwald, Jeffrey E" uniqKey="Gershenwald J" first="Jeffrey E." last="Gershenwald">Jeffrey E. Gershenwald</name><name sortKey="Lee, Jeffrey E" sort="Lee, Jeffrey E" uniqKey="Lee J" first="Jeffrey E." last="Lee">Jeffrey E. Lee</name><name sortKey="Ross, Merrick I" sort="Ross, Merrick I" uniqKey="Ross M" first="Merrick I." last="Ross">Merrick I. Ross</name><name sortKey="Shaitelman, Simona F" sort="Shaitelman, Simona F" uniqKey="Shaitelman S" first="Simona F." last="Shaitelman">Simona F. Shaitelman</name><name sortKey="Stewart, Bob R" sort="Stewart, Bob R" uniqKey="Stewart B" first="Bob R." last="Stewart">Bob R. Stewart</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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