Garza R 3rd, Skoracki R, Hock K, Povoski SP, et al.
BMC cancer. Date of publication 2017 Jul 5;volume 17(1):468.
1. BMC Cancer. 2017 Jul 5;17(1):468. doi: 10.1186/s12885-017-3444-9.
A comprehensive overview on the surgical management of secondary lymphedema of
the upper and lower extremities related to prior oncologic therapies.
Garza R 3rd(1), Skoracki R(2), Hock K(3), Povoski SP(4).
Author information:
(1)PRMA Plastic Surgery, San Antonio, TX, 78240, USA.
(2)Department of Plastic Surgery, Arthur G. James Cancer Hospital and Richard J.
Solove Research Institute and Comprehensive Cancer Center, The Ohio State
University Wexner Medical Center, Columbus, OH, 43210, USA.
roman.skoracki@osumc.edu.
(3)Division of Oncology Rehabilitation Services, Arthur G. James Cancer Hospital
and Richard J. Solove Research Institute and Comprehensive Cancer Center, The
Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA.
(4)Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer
Hospital and Richard J. Solove Research Institute and Comprehensive Cancer
Center, The Ohio State University Wexner Medical Center, Columbus, OH, 43210,
USA. stephen.povoski@osumc.edu.
Secondary lymphedema of the upper and lower extremities related to prior
oncologic therapies, including cancer surgeries, radiation therapy, and
chemotherapy, is a major cause of long-term morbidity in cancer patients. For the
upper extremities, it is most commonly associated with prior oncologic therapies
for breast cancer, while for the lower extremities, it is most commonly
associated with oncologic therapies for gynecologic cancers, urologic cancers,
melanoma, and lymphoma. Both non-surgical and surgical management strategies have
been developed and utilized, with the primary goal of all management strategies
being volume reduction of the affected extremity, improvement in patient
symptomology, and the reduction/elimination of resultant extremity-related
morbidities, including recurrent infections. Surgical management strategies
include: (i) ablative surgical methods (i.e., Charles procedure, suction-assisted
lipectomy/liposuction) and (ii) physiologic surgical methods (i.e.,
lymphaticolymphatic bypass, lymphaticovenular anastomosis, vascularized lymph
node transfer, vascularized omental flap transfer). While these surgical
management strategies can result in dramatic improvement in extremity-related
symptomology and improve quality of life for these cancer patients, many
formidable challenges remain for successful management of secondary lymphedema.
It is hopeful that ongoing clinical research efforts will ultimately lead to more
complete and sustainable treatment strategies and perhaps a cure for secondary
lymphedema and its devastating resultant morbidities.
DOI: 10.1186/s12885-017-3444-9
PMCID: PMC5497342
PMID: 28679373 [Indexed for MEDLINE]
