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This summary is adapted with permission, and highlights the findings of an original study in ePlasty, which can be found here. 

How might clinicians approach lymphedema in patients with advanced cancer receiving palliative care? A recent piece published in ePlasty looked at one center’s experience and findings.¹ When lymphedema arises as a complication of various cancers, the impact on patients can be significant. This study’s authors took a closer look at the outcomes of various treatment methods for lymphedema in patients with a palliative care plan for their advanced cancer diagnoses. 

The study first addressed 202 patients with lymphedema in this population over a more than 8-year period.1 They compared lymphedema indices derived from multiple extremity circumference measurements and body mass index (BMI) at each patient’s first and last visits. Treatment regimens included skin care, compression therapy, and lymphaticovenular anastomosis among the patients. The analysis ultimately included 38 patients with 45 affected limbs (including upper and lower extremities).¹

The authors did not note any significant change in edema based on the indices after the last visit, nor did they report significant pain relief. The compression garment yielded a 3.6 ± 10.8% rate of change in edema, which was not statistically significant, nor were the results from the lymphaticovenicular anastomosis.¹

Overall, the authors concluded that all of the treatments had limited impact, and that they did not identify any significant differences between the interventions. They noted limitations in the sample size and short follow-up possibly leading to bias, and a lack of patient-reported outcomes focusing on quality of life.¹ Specifically, they note that quality of life is an important metric in this population, as such edema may increase as their disease progresses. Stressing that respecting the patient’s wishes during treatment is paramount, and that incorporating the quality of life metric into future research would be advantageous in leading to the establishment of practice guidelines in this area.¹

Reference

1. Shimbo K, Kawamoto H, Koshima I. Treatment of Lymphedema in Patients With Advanced Cancer Receiving Palliative Care: A Single-Center Experience. Eplasty. 2024 May 9;24:e29. PMID: 38846504; PMCID: PMC11155378.