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RESEARCH PRODUCT
Validity of the Novel Taiwan Lymphoscintigraphy Staging and Correlation of Cheng Lymphedema Grading for Unilateral Extremity Lymphedema
Ming-huei ChengChieh LinChia-yu LinKevin C. ChungMarco PappalardoMarco PappalardoChang-fu Kuosubject
Malemedicine.medical_specialtyValidation studyextremity lymphedemaTreatment outcomeTaiwanMEDLINEbreast cancer-related lymphedema030230 surgery03 medical and health scienceslymphoscintigraphy0302 clinical medicinehemic and lymphatic diseasesmedicineHumansLymphedemaGrading (tumors)breast cancer-related lymphedema; extremity lymphedema; lymphatic microsurgery; lymphedema diagnosis; Cheng Lymphedema Grading System; lymphoscintigraphy; Extremities; Female; Humans; Lymphedema; Lymphoscintigraphy; Male; Middle Aged; Reproducibility of Results; TaiwanExtramuralbusiness.industryReproducibility of ResultsExtremitiesMiddle Agedmedicine.diseaselymphatic microsurgeryhumanitiesbody regionsLymphedema030220 oncology & carcinogenesisCheng Lymphedema Grading SystemFemaleSurgeryRadiologylymphedema diagnosibusinessBreast Cancer Related Lymphedemadescription
Objective: The aim was to validate the new Taiwan Lymphoscintigraphy Staging, correlate it with Cheng Lymphedema Grading (CLG) and evaluate the treatment outcomes of unilateral extremity lymphedema. Background: No consensus has been reached for diagnosis and staging for patients with lymphedema among medical specialties. Methods: We included 285 patients with unilateral extremity lymphedema using lymphoscintigraphy. Lymphoscintigraphy was correlated to clinical symptoms and signs, and classified into normal lymphatic drainage, partial obstruction, and total obstruction. Inter- and intraobserver reliability of Taiwan Lymphoscintigraphy Staging, correlation between Taiwan Lymphoscintigraphy Staging and clinical findings were conducted. Patients were categorized in surgical (n = 154) or nonsurgical (n = 131) groups for outcome evaluation. Results: Lymphoscintigraphy found 11 patients (3.9%) with normal lymphatic drainage, 128 (44.9%) with partial obstruction, and 146 (51.2%) with total obstruction. Taiwan Lymphoscintigraphy Staging showed high interobserver agreement [intraclass correlation coefficient: 0.89 (95% confidence interval, 0.82-0.94)], and significantly correlated to computed tomography volumetric difference (r = 0.66, P < 0.001) and CLG [intraclass correlation coefficient: 0.79 (95% confidence interval 0.72-0.84)]. At a mean follow-up of 31.22.9 months, significant improvement in the circumferential difference (from 23.9%+/- 17.6% to 14.6%+/- 11.1%; P = 0.03) with a mean circumferential reduction rate of 40.4%+/- 4.5% was found in surgical group. At a mean follow-up of 26.6 +/- 8.7 months, the nonsurgical group had increase of mean circumferential difference from 24.0%+/- 17.2% to 25.3%+/- 19.0% (P = 0.09), with a mean circumferential reduction rate was -1.9%+/- 13.0%. Conclusions: The Taiwan Lymphoscintigraphy Staging is a reliable diagnostic tool, correlated with clinical findings and CLG, aiding in the selection of the appropriate treatment to achieve favorable long-term outcomes in unilateral extremity lymphedema.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |