Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective
Purpose We investigated whether a one-stage combination of vascularized lymph node transfer (VLNT) with water jet-assisted liposuction (WAL) can be safely performed and results in improved patient outcomes such as a greater reduction in arm volume when treating chronic breast cancer-related lymphede...
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| Veröffentlicht in: | Breast cancer research and treatment 2023-01, Vol.197 (1), p.83-92 |
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| creator | Ghazaleh, Alina A. Handschin, Tristan M. Buckowiecki, Julia Chammartin, Frédérique S. Andree, Christoph Schaefer, Dirk J. Haug, Martin Kappos, Elisabeth A. Seidenstuecker, Katrin |
| description | Purpose
We investigated whether a one-stage combination of vascularized lymph node transfer (VLNT) with water jet-assisted liposuction (WAL) can be safely performed and results in improved patient outcomes such as a greater reduction in arm volume when treating chronic breast cancer-related lymphedema (BCRL).
Methods
In this retrospective cohort study, we included all patients from our encrypted lymphedema database treated for chronic BCRL with VLNT or VLNT + WAL who had a minimum follow-up of two years. We analyzed patient-specific variables including arm circumferences as well as patient-reported outcomes before and after surgery as well as surgery time, surgery-related complications and patient satisfaction.
Results
Only the mean preoperative differences of the circumferences between the lymphedematous and the unaffected arm in individual patients showed a statistically significant difference between treatment groups (
p
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| doi_str_mv | 10.1007/s10549-022-06778-y |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9823021</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A732480343</galeid><sourcerecordid>A732480343</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-3f27316519afb76f4aaa3c0d72096750b406f86d50b5022ac42e02c43bf731f23</originalsourceid><addsrcrecordid>eNp9Uk2PFCEUJEbjjqt_wIMh8bIeen1ANzQeTNaJX8kkJkbPhKZhhk03jNC9yZz867LT665rjOEAPKrqpYqH0HMC5wRAvM4EmlpWQGkFXIi2OjxAK9IIVglKxEO0AsJFxVvgJ-hJzpcAIAXIx-iEcdoKBnKFfq7j2PngwxYna2LIU5rN5K8s1qHHuhv08ZLntPVGD3hKVk-jDROODptdisEb3JVinrDRwdhUJVtItsfDYdzvbG9Hjc_erb9uXr3BWbtF2Dpnj22eokdOD9k-u9lP0fcP77-tP1WbLx8_ry82lWlqMlXMUcEIb4jUrhPc1VprZqAXFCQXDXQ1cNfyvpyakoc2NbVATc06V3iOslP0dtHdz91oe1McJD2offKjTgcVtVf3X4LfqW28UrKlDCgpAmc3Ain-mG2e1OizscOgg41zVlRQCVQ0dVOgL_-CXsY5hWKvoDipqaRS3qG2erDKBxdLX3Mtqi4Eo3ULrGYFdf4PVFklV1_-yzpf6vcIdCGYFHNO1t16JKCux0YtY6NKTOo4NupQSC_-TOeW8ntOCoAtgFyewtamO0v_kf0FvGXOPA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2761429299</pqid></control><display><type>article</type><title>Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective</title><source>SpringerLink Journals - AutoHoldings</source><creator>Ghazaleh, Alina A. ; Handschin, Tristan M. ; Buckowiecki, Julia ; Chammartin, Frédérique S. ; Andree, Christoph ; Schaefer, Dirk J. ; Haug, Martin ; Kappos, Elisabeth A. ; Seidenstuecker, Katrin</creator><creatorcontrib>Ghazaleh, Alina A. ; Handschin, Tristan M. ; Buckowiecki, Julia ; Chammartin, Frédérique S. ; Andree, Christoph ; Schaefer, Dirk J. ; Haug, Martin ; Kappos, Elisabeth A. ; Seidenstuecker, Katrin</creatorcontrib><description>Purpose
We investigated whether a one-stage combination of vascularized lymph node transfer (VLNT) with water jet-assisted liposuction (WAL) can be safely performed and results in improved patient outcomes such as a greater reduction in arm volume when treating chronic breast cancer-related lymphedema (BCRL).
Methods
In this retrospective cohort study, we included all patients from our encrypted lymphedema database treated for chronic BCRL with VLNT or VLNT + WAL who had a minimum follow-up of two years. We analyzed patient-specific variables including arm circumferences as well as patient-reported outcomes before and after surgery as well as surgery time, surgery-related complications and patient satisfaction.
Results
Only the mean preoperative differences of the circumferences between the lymphedematous and the unaffected arm in individual patients showed a statistically significant difference between treatment groups (
p
< 0.05). Indeed, patients treated with VLNT + WAL had consistently larger differences in individual sets of arms and therefore more pronounced chronic BCRL. The mean surgery time was significantly longer in the VLNT + WAL group (
p
< 0.05). Complications were seldom and similar in both groups. Using a numeric rating scale, the level of patient satisfaction following treatment did not differ significantly between groups (
p
= 0.323).
Conclusions
Our findings suggest that a one-stage combination of VLNT with WAL does not result in more complications even though it also entails a longer surgery time. This is acceptable as secondary interventions resulting in overall longer surgery times and higher costs can be avoided. A one-stage combination might be especially favourable for patients suffering from more severe chronic BCRL.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-022-06778-y</identifier><identifier>PMID: 36287309</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Analysis ; Breast cancer ; Cancer ; Cancer research ; Cancer therapies ; Care and treatment ; Clinical Trial ; Lymph nodes ; Lymphedema ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Oncology ; Patient satisfaction ; Patients ; Statistical analysis ; Surgery</subject><ispartof>Breast cancer research and treatment, 2023-01, Vol.197 (1), p.83-92</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2023 Springer</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-3f27316519afb76f4aaa3c0d72096750b406f86d50b5022ac42e02c43bf731f23</citedby><cites>FETCH-LOGICAL-c541t-3f27316519afb76f4aaa3c0d72096750b406f86d50b5022ac42e02c43bf731f23</cites><orcidid>0000-0002-4384-6319</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-022-06778-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-022-06778-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36287309$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghazaleh, Alina A.</creatorcontrib><creatorcontrib>Handschin, Tristan M.</creatorcontrib><creatorcontrib>Buckowiecki, Julia</creatorcontrib><creatorcontrib>Chammartin, Frédérique S.</creatorcontrib><creatorcontrib>Andree, Christoph</creatorcontrib><creatorcontrib>Schaefer, Dirk J.</creatorcontrib><creatorcontrib>Haug, Martin</creatorcontrib><creatorcontrib>Kappos, Elisabeth A.</creatorcontrib><creatorcontrib>Seidenstuecker, Katrin</creatorcontrib><title>Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
We investigated whether a one-stage combination of vascularized lymph node transfer (VLNT) with water jet-assisted liposuction (WAL) can be safely performed and results in improved patient outcomes such as a greater reduction in arm volume when treating chronic breast cancer-related lymphedema (BCRL).
Methods
In this retrospective cohort study, we included all patients from our encrypted lymphedema database treated for chronic BCRL with VLNT or VLNT + WAL who had a minimum follow-up of two years. We analyzed patient-specific variables including arm circumferences as well as patient-reported outcomes before and after surgery as well as surgery time, surgery-related complications and patient satisfaction.
Results
Only the mean preoperative differences of the circumferences between the lymphedematous and the unaffected arm in individual patients showed a statistically significant difference between treatment groups (
p
< 0.05). Indeed, patients treated with VLNT + WAL had consistently larger differences in individual sets of arms and therefore more pronounced chronic BCRL. The mean surgery time was significantly longer in the VLNT + WAL group (
p
< 0.05). Complications were seldom and similar in both groups. Using a numeric rating scale, the level of patient satisfaction following treatment did not differ significantly between groups (
p
= 0.323).
Conclusions
Our findings suggest that a one-stage combination of VLNT with WAL does not result in more complications even though it also entails a longer surgery time. This is acceptable as secondary interventions resulting in overall longer surgery times and higher costs can be avoided. A one-stage combination might be especially favourable for patients suffering from more severe chronic BCRL.</description><subject>Analysis</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Clinical Trial</subject><subject>Lymph nodes</subject><subject>Lymphedema</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Oncology</subject><subject>Patient satisfaction</subject><subject>Patients</subject><subject>Statistical analysis</subject><subject>Surgery</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9Uk2PFCEUJEbjjqt_wIMh8bIeen1ANzQeTNaJX8kkJkbPhKZhhk03jNC9yZz867LT665rjOEAPKrqpYqH0HMC5wRAvM4EmlpWQGkFXIi2OjxAK9IIVglKxEO0AsJFxVvgJ-hJzpcAIAXIx-iEcdoKBnKFfq7j2PngwxYna2LIU5rN5K8s1qHHuhv08ZLntPVGD3hKVk-jDROODptdisEb3JVinrDRwdhUJVtItsfDYdzvbG9Hjc_erb9uXr3BWbtF2Dpnj22eokdOD9k-u9lP0fcP77-tP1WbLx8_ry82lWlqMlXMUcEIb4jUrhPc1VprZqAXFCQXDXQ1cNfyvpyakoc2NbVATc06V3iOslP0dtHdz91oe1McJD2offKjTgcVtVf3X4LfqW28UrKlDCgpAmc3Ain-mG2e1OizscOgg41zVlRQCVQ0dVOgL_-CXsY5hWKvoDipqaRS3qG2erDKBxdLX3Mtqi4Eo3ULrGYFdf4PVFklV1_-yzpf6vcIdCGYFHNO1t16JKCux0YtY6NKTOo4NupQSC_-TOeW8ntOCoAtgFyewtamO0v_kf0FvGXOPA</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Ghazaleh, Alina A.</creator><creator>Handschin, Tristan M.</creator><creator>Buckowiecki, Julia</creator><creator>Chammartin, Frédérique S.</creator><creator>Andree, Christoph</creator><creator>Schaefer, Dirk J.</creator><creator>Haug, Martin</creator><creator>Kappos, Elisabeth A.</creator><creator>Seidenstuecker, Katrin</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4384-6319</orcidid></search><sort><creationdate>20230101</creationdate><title>Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective</title><author>Ghazaleh, Alina A. ; Handschin, Tristan M. ; Buckowiecki, Julia ; Chammartin, Frédérique S. ; Andree, Christoph ; Schaefer, Dirk J. ; Haug, Martin ; Kappos, Elisabeth A. ; Seidenstuecker, Katrin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-3f27316519afb76f4aaa3c0d72096750b406f86d50b5022ac42e02c43bf731f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analysis</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Clinical Trial</topic><topic>Lymph nodes</topic><topic>Lymphedema</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Oncology</topic><topic>Patient satisfaction</topic><topic>Patients</topic><topic>Statistical analysis</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghazaleh, Alina A.</creatorcontrib><creatorcontrib>Handschin, Tristan M.</creatorcontrib><creatorcontrib>Buckowiecki, Julia</creatorcontrib><creatorcontrib>Chammartin, Frédérique S.</creatorcontrib><creatorcontrib>Andree, Christoph</creatorcontrib><creatorcontrib>Schaefer, Dirk J.</creatorcontrib><creatorcontrib>Haug, Martin</creatorcontrib><creatorcontrib>Kappos, Elisabeth A.</creatorcontrib><creatorcontrib>Seidenstuecker, Katrin</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghazaleh, Alina A.</au><au>Handschin, Tristan M.</au><au>Buckowiecki, Julia</au><au>Chammartin, Frédérique S.</au><au>Andree, Christoph</au><au>Schaefer, Dirk J.</au><au>Haug, Martin</au><au>Kappos, Elisabeth A.</au><au>Seidenstuecker, Katrin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>197</volume><issue>1</issue><spage>83</spage><epage>92</epage><pages>83-92</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
We investigated whether a one-stage combination of vascularized lymph node transfer (VLNT) with water jet-assisted liposuction (WAL) can be safely performed and results in improved patient outcomes such as a greater reduction in arm volume when treating chronic breast cancer-related lymphedema (BCRL).
Methods
In this retrospective cohort study, we included all patients from our encrypted lymphedema database treated for chronic BCRL with VLNT or VLNT + WAL who had a minimum follow-up of two years. We analyzed patient-specific variables including arm circumferences as well as patient-reported outcomes before and after surgery as well as surgery time, surgery-related complications and patient satisfaction.
Results
Only the mean preoperative differences of the circumferences between the lymphedematous and the unaffected arm in individual patients showed a statistically significant difference between treatment groups (
p
< 0.05). Indeed, patients treated with VLNT + WAL had consistently larger differences in individual sets of arms and therefore more pronounced chronic BCRL. The mean surgery time was significantly longer in the VLNT + WAL group (
p
< 0.05). Complications were seldom and similar in both groups. Using a numeric rating scale, the level of patient satisfaction following treatment did not differ significantly between groups (
p
= 0.323).
Conclusions
Our findings suggest that a one-stage combination of VLNT with WAL does not result in more complications even though it also entails a longer surgery time. This is acceptable as secondary interventions resulting in overall longer surgery times and higher costs can be avoided. A one-stage combination might be especially favourable for patients suffering from more severe chronic BCRL.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>36287309</pmid><doi>10.1007/s10549-022-06778-y</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-4384-6319</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Breast cancer research and treatment, 2023-01, Vol.197 (1), p.83-92 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9823021 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Analysis Breast cancer Cancer Cancer research Cancer therapies Care and treatment Clinical Trial Lymph nodes Lymphedema Medical research Medicine Medicine & Public Health Medicine, Experimental Oncology Patient satisfaction Patients Statistical analysis Surgery |
| title | Combining reconstructive and ablative surgical treatment of chronic breast cancer-related lymphedema (BCRL): safe and effective |
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