title: Prognostic value of lymphoscintigraphy in patients with gynecological cancer-related lymphedema.
abstract: OBJECTIVE
  We investigated the prognostic value of qualitative lymphoscintigraphy in gynecological cancer-related lymphedema, which is a common complication after treatment.
  
  
  METHODS
  All 152 patients underwent (99m) Tc tin-colloid lymphoscintigraphy before complex decongestive therapy (CDT). We analyzed the uptake patterns of the inguinal lymph nodes, main lymphatic vessel and collateral lymphatic vessels, as well as dermal back flow. We compared these lymphoscintigraphic findings and other clinical variables between good and poor therapeutic responders using Pearson's Chi-squared test, Fisher's exact test and multiple logistic regression analysis.
  
  
  RESULTS
  Eighty-nine patients (58.6%) had a poor therapeutic response to CDT. In univariate analysis, there were significant differences between good and poor responders in clinical stage (P < 0.001), therapy compliance (P < 0.001), main lymphatic vessel uptake pattern (P < 0.01), collateral lymphatic vessel uptake pattern (P < 0.01) and severity of dermal back flow (P < 0.001). After multivariate analysis, only severity of dermal back flow (P < 0.005), clinical stage (P < 0.05) and therapy compliance (P < 0.001) were found to be independent predictors of therapeutic response.
  
  
  CONCLUSIONS
  Lymphoscintigraphy may be useful to predict the outcome of patients with gynecological cancer-related lymphedema undergoing CDT along with clinical stage and compliance.
authors.affiliation: Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jang
authors.initials: J
authors.lastname: Yoo
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Hwang
authors.forename: Dong Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Kim
authors.forename: Yearn Seong
authors.initials: YS
authors.lastname: Choe
authors.forename: Kyung-Han
authors.initials: KH
authors.lastname: Lee
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D042601:Lymphatic Vessels / Q000000981:diagnostic imaging*; D008209:Lymphedema / Q000000981:diagnostic imaging* / Q000209:etiology; D061305:Lymphoscintigraphy; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid
keywords: cancer; complex decongestive therapy; lymphedema; lymphoscintigraphy; prognosis