Effectiveness of upper extremity lymphaticovenular anastomosis for breast cancer-related trunk lymphedema: Evaluating with a novel subjective scoring system.

BACKGROUND

Secondary trunk lymphedema (TL) commonly develops after breast cancer treatment (BCT) and frequently exists with upper extremity lymphedema (UEL). Although several diagnostic methods have been proposed, treatment options are mainly limited to manual lymphatic drainage (MLD). In this study, the efficacy of upper extremity lymphaticovenular anastomosis (LVA) for TL was evaluated.

METHODS

Patients with secondary TL after BCT who underwent complex decongestive therapy for over 6 months, followed by upper extremity LVA, were included in this study. Subjective trunk symptoms were assessed using the novel patient-reported outcome measure-Trunk Lymphedema Index for Patients (TuLIP). Moreover, upper extremity volume (UV); upper extremity lymphedema index (UELI): a body size-adjusted assessment of arm volume; and the lymphedema quality-of-life score (LeQOLiS) were used to assess subjective symptoms of UEL. Outcomes were reassessed 6 months postoperatively.

RESULTS

Forty-six cases were included and 29 patients completed the TuLIP assessment at the initial examination and 6 months after LVA. The total TuLIP significantly decreased from 16.7 to 10.3 (P = 0.020). The mean UV, UELI, and total LeQOLiS changed from 1125.4 to 1095.8 (P = 0.095), 108.3 to 105.2 (P = 0.040), and 22.5 to 15.6 (P = 0.005), respectively.

CONCLUSIONS

Upper extremity LVA may be effective in decreasing certain TL symptoms following BCT. Moreover, TuLIP may be a useful tool for evaluating subjective symptoms of TL.