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The effect of smoking and major vein resection on post-therapy lymphedema in soft tissue sarcomas treated with neoadjuvant radiation and limb-salvage surgery. Am J Clin Oncol 2015 Apr;38(2):184-8

Date

04/09/2013

Pubmed ID

23563214

DOI

10.1097/COC.0b013e31828aadc9

Scopus ID

2-s2.0-84926408438   5 Citations

Abstract

BACKGROUND: Neoadjuvant therapy with radiation +/- chemotherapy is an accepted management for soft tissue sarcomas (STS). The incidence of post-therapy lymphedema is around 30%. The purpose of this study was to identify variables that predict for post-therapy lymphedema.

METHODS: From 2000 to 2010, 132 patients with STS were treated with neoadjuvant radiation +/- chemotherapy followed by resection. Patient variables and treatment outcomes were reviewed. Presence of lymphedema was determined by the treating physician. The Fisher exact test was used for univariate analysis and logistic regression was used for multivariate analysis.

RESULTS: Median follow-up was 3.1 years. Of the lower extremity STS, major veins were sacrificed in 34% of patients. Lymphedema occurred in 22.4% of patients. Smoking negatively predicted for lymphedema on univariate analysis (P=0.007), and sacrifice of a major vein was associated with an increased risk of lymphedema (P=0.02). On multivariate analysis, smoking (P=0.02, odds ratio 0.31) negatively predicted for and sacrifice of a major vein (P=0.03, odds ratio 2.7) positively predicted for lymphedema.

CONCLUSIONS: There may be an association between smoking and decrease post-therapy lymphedema. Also, patients who undergo resection of a major vein seem to be more prone to post-therapy lymphedema.

Author List

Bedi M, King DM, Whitfield R, Hackbarth DA, Neilson JC, Charlson JA, Wang D

Authors

Manpreet Bedi MD Associate Professor in the Radiation Oncology department at Medical College of Wisconsin
John A. Charlson MD Associate Professor in the Medicine department at Medical College of Wisconsin
David M. King MD Chair, Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
John C. Neilson MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Combined Modality Therapy
Female
Humans
Lymphedema
Male
Middle Aged
Postoperative Complications
Risk Factors
Sarcoma
Smoking
Vascular Surgical Procedures
Veins
Young Adult