Prospective Assessment of Lymphedema Incidence and Lymphedema-associated Symptoms Following Lymph Node Surgery for Melanoma
Identifieur interne : 002040 ( Pmc/Checkpoint ); précédent : 002039; suivant : 002041Prospective Assessment of Lymphedema Incidence and Lymphedema-associated Symptoms Following Lymph Node Surgery for Melanoma
Auteurs : John R. Hyngstrom [États-Unis] ; Yi-Ju Chiang [États-Unis] ; Kate D. Cromwell [États-Unis] ; Merrick I. Ross [États-Unis] ; Yan Xing [États-Unis] ; Kristi S. Mungovan [États-Unis] ; Jeffrey E. Lee ; Jeffrey E. Gershenwald [États-Unis] ; Richard E. Royal [États-Unis] ; Anthony Lucci [États-Unis] ; Jane M. Armer [États-Unis] ; Janice N. Cormier [États-Unis]Source :
- Melanoma research [ 0960-8931 ] ; 2013.
Abstract
We sought to prospectively assess limb volume change (LVC) and associated symptoms in patients with melanoma undergoing sentinel lymph node (SLN) biopsy and/or therapeutic lymph node dissection (TLND).
Limb volume was measured pre-operatively and post-operatively at 6 and 12 months using a perometer (JUZO 1000M). LVC calculated and used to define 3 groups: <5%, 5-10%, and >10%. A 19-item lymphedema symptom questionnaire was administered at baseline, 6-month and 12-months.
One hundred eighty-two patients were enrolled. Twelve months after axillary surgery, 9% had LVC 5-10%, and 13% had LVC >10%. Twelve months after inguino-femoral surgery, 10% had LVC 5-10%, and 13% had LVC >10%. There was a significant 7- to 9-fold increase in symptoms for patients with LVC greater than >10% compared to those with LVC <5% (
LVC greater than 5% is common at 12 months following nodal surgery for melanoma and is associated with symptoms. Informed consent for melanoma patients undergoing lymph node surgery should include a discussion of the risks of post-operative lymphedema.
Url:
DOI: 10.1097/CMR.0b013e3283632c83
PubMed: 23752305
PubMed Central: 3881422
Affiliations:
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Hyngstrom</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="Cromwell, Kate D" sort="Cromwell, Kate D" uniqKey="Cromwell K" first="Kate D." last="Cromwell">Kate D. 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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></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23752305</idno><idno type="pmc">3881422</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881422</idno><idno type="RBID">PMC:3881422</idno><idno type="doi">10.1097/CMR.0b013e3283632c83</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">003899</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003899</idno><idno type="wicri:Area/Pmc/Curation">003898</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">003898</idno><idno type="wicri:Area/Pmc/Checkpoint">002040</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002040</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Prospective Assessment of Lymphedema Incidence and Lymphedema-associated Symptoms Following Lymph Node Surgery for Melanoma</title><author><name sortKey="Hyngstrom, John R" sort="Hyngstrom, John R" uniqKey="Hyngstrom J" first="John R." last="Hyngstrom">John R. Hyngstrom</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="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="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="Xing, Yan" sort="Xing, Yan" uniqKey="Xing Y" first="Yan" last="Xing">Yan Xing</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="Mungovan, Kristi S" sort="Mungovan, Kristi S" uniqKey="Mungovan K" first="Kristi S." last="Mungovan">Kristi S. Mungovan</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></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="Royal, Richard E" sort="Royal, Richard E" uniqKey="Royal R" first="Richard E." last="Royal">Richard E. Royal</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="Lucci, Anthony" sort="Lucci, Anthony" uniqKey="Lucci A" first="Anthony" last="Lucci">Anthony Lucci</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">Sinclair School of Nursing/Ellis Fischel Cancer Center, Sinclair School of Nursing, University of Missouri, Columbia, MO</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Missouri (État)</region></placeName><wicri:cityArea>Sinclair School of Nursing/Ellis Fischel Cancer Center, Sinclair School of Nursing, University of Missouri, Columbia</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">Melanoma research</title><idno type="ISSN">0960-8931</idno><idno type="eISSN">1473-5636</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Aims</title><p id="P1">We sought to prospectively assess limb volume change (LVC) and associated symptoms in patients with melanoma undergoing sentinel lymph node (SLN) biopsy and/or therapeutic lymph node dissection (TLND).</p></sec><sec id="S2"><title>Methods</title><p id="P2">Limb volume was measured pre-operatively and post-operatively at 6 and 12 months using a perometer (JUZO 1000M). LVC calculated and used to define 3 groups: <5%, 5-10%, and >10%. A 19-item lymphedema symptom questionnaire was administered at baseline, 6-month and 12-months.</p></sec><sec id="S3"><title>Results</title><p id="P3">One hundred eighty-two patients were enrolled. Twelve months after axillary surgery, 9% had LVC 5-10%, and 13% had LVC >10%. Twelve months after inguino-femoral surgery, 10% had LVC 5-10%, and 13% had LVC >10%. There was a significant 7- to 9-fold increase in symptoms for patients with LVC greater than >10% compared to those with LVC <5% (<italic>P</italic><.05). By multivariate analysis, TLND versus SLN biopsy (odds ratio [OR] = 3.18 <italic>P</italic><0.01) and borderline significance for lower-versus upper-extremity procedures (OR=1.72; <italic>P</italic>=0.07) were associated with LVC >5%.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">LVC greater than 5% is common at 12 months following nodal surgery for melanoma and is associated with symptoms. Informed consent for melanoma patients undergoing lymph node surgery should include a discussion of the risks of post-operative lymphedema.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9109623</journal-id><journal-id journal-id-type="pubmed-jr-id">2214</journal-id><journal-id journal-id-type="nlm-ta">Melanoma Res</journal-id><journal-id journal-id-type="iso-abbrev">Melanoma Res.</journal-id><journal-title-group><journal-title>Melanoma research</journal-title></journal-title-group><issn pub-type="ppub">0960-8931</issn><issn pub-type="epub">1473-5636</issn></journal-meta><article-meta><article-id pub-id-type="pmid">23752305</article-id><article-id pub-id-type="pmc">3881422</article-id><article-id pub-id-type="doi">10.1097/CMR.0b013e3283632c83</article-id><article-id pub-id-type="manuscript">NIHMS529082</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Prospective Assessment of Lymphedema Incidence and Lymphedema-associated Symptoms Following Lymph Node Surgery for Melanoma</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hyngstrom</surname><given-names>John R.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Chiang</surname><given-names>Yi-Ju</given-names></name><degrees>MSPH</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Cromwell</surname><given-names>Kate D.</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Ross</surname><given-names>Merrick I.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Xing</surname><given-names>Yan</given-names></name><degrees>MD, MS, PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mungovan</surname><given-names>Kristi S.</given-names></name><degrees>MS, PA-C</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Jeffrey E.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Gershenwald</surname><given-names>Jeffrey E.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Royal</surname><given-names>Richard E.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lucci</surname><given-names>Anthony</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Armer</surname><given-names>Jane M.</given-names></name><degrees>RN, PhD FAAN</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Cormier</surname><given-names>Janice N.</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="corresp" rid="CR1">*</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</aff><aff id="A2"><label>2</label>Sinclair School of Nursing/Ellis Fischel Cancer Center, Sinclair School of Nursing, University of Missouri, Columbia, MO</aff><author-notes><corresp id="CR1"><label>*</label>Correspondence: Address: Department of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, P.O. Box 301402, Houston, Texas 77030-1402, <email>jcormier@mdanderson.org</email>, Phone: 713-792-6949, Fax: 713-745-1921
</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>30</day><month>11</month><year>2013</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2013</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>8</month><year>2014</year></pub-date><volume>23</volume><issue>4</issue><elocation-id>10.1097/CMR.0b013e3283632c83</elocation-id><abstract><sec id="S1"><title>Aims</title><p id="P1">We sought to prospectively assess limb volume change (LVC) and associated symptoms in patients with melanoma undergoing sentinel lymph node (SLN) biopsy and/or therapeutic lymph node dissection (TLND).</p></sec><sec id="S2"><title>Methods</title><p id="P2">Limb volume was measured pre-operatively and post-operatively at 6 and 12 months using a perometer (JUZO 1000M). LVC calculated and used to define 3 groups: <5%, 5-10%, and >10%. A 19-item lymphedema symptom questionnaire was administered at baseline, 6-month and 12-months.</p></sec><sec id="S3"><title>Results</title><p id="P3">One hundred eighty-two patients were enrolled. Twelve months after axillary surgery, 9% had LVC 5-10%, and 13% had LVC >10%. Twelve months after inguino-femoral surgery, 10% had LVC 5-10%, and 13% had LVC >10%. There was a significant 7- to 9-fold increase in symptoms for patients with LVC greater than >10% compared to those with LVC <5% (<italic>P</italic><.05). By multivariate analysis, TLND versus SLN biopsy (odds ratio [OR] = 3.18 <italic>P</italic><0.01) and borderline significance for lower-versus upper-extremity procedures (OR=1.72; <italic>P</italic>=0.07) were associated with LVC >5%.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">LVC greater than 5% is common at 12 months following nodal surgery for melanoma and is associated with symptoms. Informed consent for melanoma patients undergoing lymph node surgery should include a discussion of the risks of post-operative lymphedema.</p></sec></abstract><kwd-group><kwd>melanoma</kwd><kwd>lymphedema</kwd><kwd>perometry</kwd><kwd>symptom assessment</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Cancer Institute : NCI</funding-source><award-id>P30 CA016672 || CA</award-id></award-group></funding-group></article-meta></front></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Missouri (État)</li><li>Texas</li></region></list><tree><noCountry><name sortKey="Lee, Jeffrey E" sort="Lee, Jeffrey E" uniqKey="Lee J" first="Jeffrey E." last="Lee">Jeffrey E. Lee</name></noCountry><country name="États-Unis"><region name="Texas"><name sortKey="Hyngstrom, John R" sort="Hyngstrom, John R" uniqKey="Hyngstrom J" first="John R." last="Hyngstrom">John R. Hyngstrom</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="Lucci, Anthony" sort="Lucci, Anthony" uniqKey="Lucci A" first="Anthony" last="Lucci">Anthony Lucci</name><name sortKey="Mungovan, Kristi S" sort="Mungovan, Kristi S" uniqKey="Mungovan K" first="Kristi S." last="Mungovan">Kristi S. Mungovan</name><name sortKey="Ross, Merrick I" sort="Ross, Merrick I" uniqKey="Ross M" first="Merrick I." last="Ross">Merrick I. Ross</name><name sortKey="Royal, Richard E" sort="Royal, Richard E" uniqKey="Royal R" first="Richard E." last="Royal">Richard E. Royal</name><name sortKey="Xing, Yan" sort="Xing, Yan" uniqKey="Xing Y" first="Yan" last="Xing">Yan Xing</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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