A comprehensive overview on the surgical management of secondary lymphedema of the upper and lower extremities related to prior oncologic therapies
Identifieur interne : 000439 ( Pmc/Checkpoint ); précédent : 000438; suivant : 000440A comprehensive overview on the surgical management of secondary lymphedema of the upper and lower extremities related to prior oncologic therapies
Auteurs : Ramon Garza [États-Unis] ; Roman Skoracki [États-Unis] ; Karen Hock [États-Unis] ; Stephen P. Povoski [États-Unis]Source :
- BMC Cancer [ 1471-2407 ] ; 2017.
Abstract
Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgical and surgical management strategies have been developed and utilized, with the primary goal of all management strategies being volume reduction of the affected extremity, improvement in patient symptomology, and the reduction/elimination of resultant extremity-related morbidities, including recurrent infections. Surgical management strategies include: (i) ablative surgical methods (i.e., Charles procedure, suction-assisted lipectomy/liposuction) and (ii) physiologic surgical methods (i.e., lymphaticolymphatic bypass, lymphaticovenular anastomosis, vascularized lymph node transfer, vascularized omental flap transfer). While these surgical management strategies can result in dramatic improvement in extremity-related symptomology and improve quality of life for these cancer patients, many formidable challenges remain for successful management of secondary lymphedema. It is hopeful that ongoing clinical research efforts will ultimately lead to more complete and sustainable treatment strategies and perhaps a cure for secondary lymphedema and its devastating resultant morbidities.
Url:
DOI: 10.1186/s12885-017-3444-9
PubMed: 28679373
PubMed Central: 5497342
Affiliations:
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<front><div type="abstract" xml:lang="en"><p id="Par1">Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgical and surgical management strategies have been developed and utilized, with the primary goal of all management strategies being volume reduction of the affected extremity, improvement in patient symptomology, and the reduction/elimination of resultant extremity-related morbidities, including recurrent infections. Surgical management strategies include: (i) ablative surgical methods (i.e., Charles procedure, suction-assisted lipectomy/liposuction) and (ii) physiologic surgical methods (i.e., lymphaticolymphatic bypass, lymphaticovenular anastomosis, vascularized lymph node transfer, vascularized omental flap transfer). While these surgical management strategies can result in dramatic improvement in extremity-related symptomology and improve quality of life for these cancer patients, many formidable challenges remain for successful management of secondary lymphedema. It is hopeful that ongoing clinical research efforts will ultimately lead to more complete and sustainable treatment strategies and perhaps a cure for secondary lymphedema and its devastating resultant morbidities.</p>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Cancer</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Cancer</journal-id>
<journal-title-group><journal-title>BMC Cancer</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2407</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">28679373</article-id>
<article-id pub-id-type="pmc">5497342</article-id>
<article-id pub-id-type="publisher-id">3444</article-id>
<article-id pub-id-type="doi">10.1186/s12885-017-3444-9</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review</subject>
</subj-group>
</article-categories>
<title-group><article-title>A comprehensive overview on the surgical management of secondary lymphedema of the upper and lower extremities related to prior oncologic therapies</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Garza</surname>
<given-names>Ramon</given-names>
<suffix>III</suffix>
</name>
<address><email>Ramongarza3@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Skoracki</surname>
<given-names>Roman</given-names>
</name>
<address><email>roman.skoracki@osumc.edu</email>
</address>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hock</surname>
<given-names>Karen</given-names>
</name>
<address><email>karen.hock@osumc.edu</email>
</address>
<xref ref-type="aff" rid="Aff3">3</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Povoski</surname>
<given-names>Stephen P.</given-names>
</name>
<address><email>stephen.povoski@osumc.edu</email>
</address>
<xref ref-type="aff" rid="Aff4">4</xref>
</contrib>
<aff id="Aff1"><label>1</label>
PRMA Plastic Surgery, San Antonio, TX 78240 USA</aff>
<aff id="Aff2"><label>2</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1545 0811</institution-id>
<institution-id institution-id-type="GRID">grid.412332.5</institution-id>
<institution>Department of Plastic Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Comprehensive Cancer Center,</institution>
<institution>The Ohio State University Wexner Medical Center,</institution>
</institution-wrap>
Columbus, OH 43210 USA</aff>
<aff id="Aff3"><label>3</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1545 0811</institution-id>
<institution-id institution-id-type="GRID">grid.412332.5</institution-id>
<institution>Division of Oncology Rehabilitation Services, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Comprehensive Cancer Center,</institution>
<institution>The Ohio State University Wexner Medical Center,</institution>
</institution-wrap>
Columbus, OH 43210 USA</aff>
<aff id="Aff4"><label>4</label>
<institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1545 0811</institution-id>
<institution-id institution-id-type="GRID">grid.412332.5</institution-id>
<institution>Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Comprehensive Cancer Center,</institution>
<institution>The Ohio State University Wexner Medical Center,</institution>
</institution-wrap>
Columbus, OH 43210 USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>5</day>
<month>7</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>5</day>
<month>7</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="collection"><year>2017</year>
</pub-date>
<volume>17</volume>
<elocation-id>468</elocation-id>
<history><date date-type="received"><day>2</day>
<month>5</month>
<year>2017</year>
</date>
<date date-type="accepted"><day>22</day>
<month>6</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s). 2017</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><p id="Par1">Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgical and surgical management strategies have been developed and utilized, with the primary goal of all management strategies being volume reduction of the affected extremity, improvement in patient symptomology, and the reduction/elimination of resultant extremity-related morbidities, including recurrent infections. Surgical management strategies include: (i) ablative surgical methods (i.e., Charles procedure, suction-assisted lipectomy/liposuction) and (ii) physiologic surgical methods (i.e., lymphaticolymphatic bypass, lymphaticovenular anastomosis, vascularized lymph node transfer, vascularized omental flap transfer). While these surgical management strategies can result in dramatic improvement in extremity-related symptomology and improve quality of life for these cancer patients, many formidable challenges remain for successful management of secondary lymphedema. It is hopeful that ongoing clinical research efforts will ultimately lead to more complete and sustainable treatment strategies and perhaps a cure for secondary lymphedema and its devastating resultant morbidities.</p>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Lymphedema</kwd>
<kwd>Vascularized lymph node transfer</kwd>
<kwd>Lymphaticovenular bypass</kwd>
<kwd>Lymphogram</kwd>
<kwd>complete decongestive therapy</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2017</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Ohio</li>
<li>Texas</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Texas"><name sortKey="Garza, Ramon" sort="Garza, Ramon" uniqKey="Garza R" first="Ramon" last="Garza">Ramon Garza</name>
</region>
<name sortKey="Hock, Karen" sort="Hock, Karen" uniqKey="Hock K" first="Karen" last="Hock">Karen Hock</name>
<name sortKey="Povoski, Stephen P" sort="Povoski, Stephen P" uniqKey="Povoski S" first="Stephen P." last="Povoski">Stephen P. Povoski</name>
<name sortKey="Skoracki, Roman" sort="Skoracki, Roman" uniqKey="Skoracki R" first="Roman" last="Skoracki">Roman Skoracki</name>
</country>
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</record>
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