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前列腺癌治疗后淋巴水肿的特征,特别是中线淋巴水肿:一项回顾性研究。

Characteristics of lymphoedema, in particular midline lymphoedema, after treatment for prostate cancer: a retrospective study.

机构信息

Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.

Department of Urology, University Hospitals Leuven, Leuven, Belgium.

出版信息

BMC Urol. 2024 Sep 4;24(1):192. doi: 10.1186/s12894-024-01533-5.

Abstract

BACKGROUND

Patients undergoing treatment for prostate cancer may develop lymphoedema of the midline region. This has a substantial impact on a patient's quality of life and its diagnosis is often delayed or missed. Therefore, the purpose of this study is to compare the characteristics of patients with leg and midline lymphoedema to patients with only leg lymphoedema.

METHODS

We retrospectively collected patient-, cancer-, lymphoedema- and lymphoedema treatment-related data of 109 men with lymphoedema after treatment for prostate cancer. First, 42 characteristics were compared between both groups. Second, factors predicting presence of midline lymphoedema were explored by multivariable analyses.

RESULTS

The mean age of the patients with lymphoedema was 68 ( ±7) years and mean BMI is 28 (±4) kg/m. Median duration of lymphoedema before the first consultation was 27 (9;55) months. Based on univariable analyses, patients with leg and midline lymphoedema had more frequently upper leg lymphoedema (89% (31/35) vs. 69% (51/74), p = 0.026), skin fibrosis (34% (12/35) vs. 16% (12/74), p = 0.034) and lymphatic reconstructive surgery (9% (3/35) vs. 0% (0/71), p = 0.020) than patients with only leg lymphoedema. Additionally, patients with leg and midline lymphoedema reported less frequently lower leg lymphoedema (77% (27/35) vs. 95% (70/74), p = 0.007). Based on the multivariable analysis, not having lower leg lymphoedema, skin fibrosis, performing self-bandaging and self-manual lymphatic drainage appear to be predictors for having midline lymphoedema.

CONCLUSIONS

If patients with lymphoedema after prostate cancer do not have lower leg lymphoedema, have skin fibrosis, perform self-bandaging or self-manual lymphatic drainage, they possibly have midline lymphoedema.

摘要

背景

接受前列腺癌治疗的患者可能会出现中线区域的淋巴水肿。这对患者的生活质量有重大影响,其诊断常常被延迟或遗漏。因此,本研究的目的是比较下肢和中线淋巴水肿患者与仅下肢淋巴水肿患者的特征。

方法

我们回顾性地收集了 109 名接受前列腺癌治疗后出现淋巴水肿的男性患者的患者、癌症、淋巴水肿和淋巴水肿治疗相关数据。首先,比较了两组之间的 42 个特征。其次,通过多变量分析探讨了预测中线淋巴水肿存在的因素。

结果

淋巴水肿患者的平均年龄为 68(±7)岁,平均 BMI 为 28(±4)kg/m。首次就诊前淋巴水肿的中位持续时间为 27(9;55)个月。基于单变量分析,下肢和中线淋巴水肿患者更常出现大腿淋巴水肿(89%(31/35)比 69%(51/74),p=0.026)、皮肤纤维化(34%(12/35)比 16%(12/74),p=0.034)和淋巴重建手术(9%(3/35)比 0%(0/71),p=0.020)。此外,下肢和中线淋巴水肿患者下肢淋巴水肿的报告频率较低(77%(27/35)比 95%(70/74),p=0.007)。基于多变量分析,没有下肢淋巴水肿、皮肤纤维化、进行自我包扎和自我手动淋巴引流似乎是中线淋巴水肿的预测因素。

结论

如果前列腺癌治疗后出现淋巴水肿的患者没有下肢淋巴水肿、有皮肤纤维化、进行自我包扎或自我手动淋巴引流,则可能存在中线淋巴水肿。

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