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001-es BibID:	BIBFORM120914
035-os BibID:	(Scopus)85118887769 (WOS)000739385200012
Első szerző:	Borčinová, Martina
Cím:	Challenges in lower limb lymphoedema assessment based on limb volume change : lessons learnt from the SENTIX prospective multicentre study / Martina Borčinová, Volker Ragosch, Jiří Jarkovský, Sylva Bajsová, Radovan Pilka, Ariel Glickman, Sonia Garrido-Mallach, Francesco Raspagliesi, Wiktor Szatkowski, Maja Pakiz, Leon C. Snyman, Roman Kocián, Karl Tamussino, Vladimír Kalist, Martin Michal, Myriam Gracia Segovia, Robert Poka, Barbara Kipp, Grzegorz Szewczyk, Dariusz Wydra, Róbert Tóth, Alla Vinnytska, Daniela Fischerová, Kathrin Siegler, David Cibula
Dátum:	2022
ISSN:	0090-8258
Megjegyzések:	Background: Lower limb lymphoedema (LLL) is the most disabling adverse effect of surgical staging of pelvic lymph nodes. However, the lack of standardisation of volumetric LLL assessment hinders direct comparison between the studies and makes LLL reporting unreliable. The aim of our study is to report outcomes from a prospective trial that have implications for LLL assessment standardisation. Methods: In the prospective international multicentre trial SENTIX, a group of 150 patients with stage IA1?IB2 cervical cancer treated by uterine surgery with bilateral sentinel lymph node biopsy was prospectively evaluated by objective LLL assessment, based on limb volume change (LVC) using circumferrential limb measurements and subjective patient-reported swelling. The assessments were conducted in six-month periods over 24 months post-surgery. Results: Patient LVC substantially fluctuated in both positive and negative directions, which were comparable in frequency up to ?14% change. Thirty-eight patients experienced persistent LVC increase >10% classified as LLL, with nine months median time to onset. Some 34.2% of cases experienced onset later than one year after the surgery. Thirty-three patients (22%) experienced transient oedema characterised as LVC >10%, which resolved without intervention between two consequent follow-up visits. No significant correlation between LVC >10% and a patient-reported swelling was observed. Conclusions: Given that we observed comparable fluctuations of the the lower-limb volumes after surgical treatment of cervical cancer in both positive and negative direction up to ?14%, the diagnostic threshold for LLL diagnosis based on LVC should be increased to >15% LVC. The distinction of transient oedema from persistent LLL requires repeated measurements. Also, as one-third of LLL cases are diagnosed >1-year post-surgery, a sufficient follow-up duration needs to be ensured. Patient-reported swelling correlated poorly with LVC and should only be used as an adjunct to objective LLL assessment. Trial registration: ClinicalTrials.gov: NCT02494063 ? 2021 Elsevier Inc.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Assessment standardisation Cervical cancer Limb volume change Lower limb lymphedema Transient edema
Megjelenés:	Gynecologic Oncology. - 164 : 1 (2022), p. 76-84. -
További szerzők:	Ragosch, Volker Jarkovský, Jiří Bajsová, Sylva Pilka, Radovan Glickman, Ariel Garrido-Mallach, Sonia Raspagliesi, Francesco Szatkowski, Wiktor Pakiz, Maja Snyman, Leon Cornelius Kocian, Roman Tamussino, Karl Kalist, Vladimír Michal, Martin Segovia, Myriam Gracia Póka Róbert (1960-) (szülész-nőgyógyász, klinikai onkológus) Kipp, Barbara Szewczyk, Grzegorz Wydra, Dariusz Tóth Róbert Vinnytska, Alla Fischerová, Daniela Siegler, Kathrin Cibula, David
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