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Lymphedema after complete axillary node dissection for melanoma: assessment using a new, objective definition
Emma C Starritt1, David Joseph, J Gregory McKinnon
1Sydney Melanoma Unit, Sydney Cancer Centre, Royal Prince Alfred Hospital, Camperdown, Australia.
Annals of Surgery
|October 20, 2004
Summary
A new definition for lymphedema after axillary dissection is an arm volume increase over 16%. This study found 10% prevalence in melanoma patients, rising to 53% with radiotherapy, which are risk factors.
Area of Science:
- Oncology
- Surgical Oncology
- Lymphedema Research
Background:
- Objective criteria for lymphedema post-axillary dissection are lacking.
- This hinders accurate prevalence assessment in melanoma patients.
- Standardized definitions are crucial for clinical management.
Purpose of the Study:
- To establish objective criteria for lymphedema diagnosis.
- To determine lymphedema prevalence after melanoma axillary dissection.
- To identify risk factors for upper limb lymphedema.
Main Methods:
- Assessed 107 patients post-level I-III axillary dissection for melanoma.
- Measured arm volume via water displacement, comparing to the contralateral arm.
- Utilized Classification and Regression Tree (CART) analysis to define lymphedema threshold.
Main Results:
- Lymphedema defined as >16% arm volume increase relative to the control arm.
- Prevalence was 10% post-dissection alone, increasing to 53% with radiotherapy.
- Radiotherapy and wound complications independently predicted lymphedema.
Conclusions:
- Proposed objective definition: >16% arm volume increase.
- Highlights significant impact of radiotherapy on lymphedema risk.
- Emphasizes need for standardized lymphedema assessment post-surgery.