The effectiveness of complete decongestive physiotherapy for the treatment of lymphedema following groin dissection for melanoma.
OBJECTIVE
Groin dissection is performed for the treatment of melanoma and other malignancies. Lymphedema rates as high as 47% have been reported. In 1996, we began using complete decongestive physiotherapy (CDP) in selected patients with lymphedema following groin dissection. Here, we review our results in a small cohort of patients.


METHODS
A retrospective review of the medical records of 14 patients, treated with CDP for lymphedema secondary to groin dissection for melanoma was conducted. All patients were treated with CDP at Roswell Park Cancer Institute (RPCI), between 1996 and 2002. Of the 14 patients, 12 underwent groin dissection at RPCI. Response to therapy was measured by limb volume determinations. Patient gender, age, body mass index (BMI), type of operation, type of adjuvant therapy, time to treatment, patient compliance, lymphedema stage, and initial edema were analyzed for association with response to treatment. Incidence was estimated by a review of the operative logs.


RESULTS
Fourteen patients were treated with CDP for lymphedema secondary to groin dissection for melanoma, with a median decrease in lymphedema of 60% (range: 35-145%; P = 0.0003). Increased BMI was associated with a decreased response to treatment (P = 0.02). Response to CDP was not effected by time to treatment, patient compliance, lymphedema stage, and initial edema. During this time, 39 groin dissections were done at RPCI. The incidence of lymphedema treated with CDP at RPCI was 31% (12/39; standard error 7.4%).


CONCLUSIONS
With a decrease in lymphedema of 60%, CDP may provide relief for patients with lymphedema following groin dissection. Elevated BMI was associated with a decreased response to CDP.
Department of Surgical Oncology, Roswell Park Cancer Institute, State University of New York at Buffalo, Buffalo, New York, USA.
Christian S
CS
Hinrichs
John F
JF
Gibbs
Deborah
D
Driscoll
James L
JL
Kepner
Neal W
NW
Wilkinson
Stephen B
SB
Edge
Kathleen A
KA
Fassl
Robin
R
Muir
William G
WG
Kraybill
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005121:Extremities / Q000473:pathology; D005260:Female; D006119:Groin / Q000601:surgery; D006801:Humans; D015994:Incidence; D008209:Lymphedema / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008545:Melanoma / Q000601:surgery*; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies