title: Prospective multicentre observational study of lymphedema therapy: POLIT study.
abstract: OBJECTIVE
  Lymphedema treatment is based on Decongestive Lymphedema Therapy (DLT) with an intensive phase followed by a long-term maintenance phase. This study aimed to observe volume variation over the intensive phase and 6 months later.
  
  
  METHODS
  Prospective multicentre observational study of patients with unilateral lymphedema. The primary objective was to assess lymphedema volume variation between baseline, the end of intensive phase and 6 months later. Secondary objectives were to assess the frequency of heaviness limiting limb function and treatments safety predictors for volume reduction.
  
  
  RESULTS
  Three hundred and six patients (89.9% women; 59.9±14.3 years old) with upper/lower (n=184/122) limb lymphedema were included. At the end of the intensive phase, median excess lymphedema volume reduction was 31.0% (41.7-19.9) followed by a 16.5% (5.9-42.3) median increase over the 6-month maintenance period phase. Previous intensive treatment was the only significant predictor of this response. As compared to baseline, heaviness limiting limb use was much less frequently reported at the end of the reductive phase (75.5% versus 42.3% respectively), and was more frequent at the end of the maintenance phase (62.6%). The most frequent adverse events reported were skin redness and compression marks (18.4 and 15.7% of patients, respectively). Blisters requiring treatment stoppage were rare (1.4%).
  
  
  CONCLUSIONS
  Intensive phase decreases lymphedema volume and heaviness limiting limb function. The benefit is partially abolished after the first 6 months of maintenance. There is a need to consider how to provide optimal patient care for the long-term control of lymphedema.
authors.affiliation: EA 2992, Vascular Medicine Unit, CIC1001 Inserm, CHU de Montpellier, université Montpellier 1, 34295 cedex 5 Montpellier, France. Electronic address: i-quere@chu-montpellier.fr.
authors.forename: I
authors.initials: I
authors.lastname: Quéré
authors.affiliation: Inserm, CIE3, unité de recherche clinique, innovation et pharmacologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France.
authors.forename: E
authors.initials: E
authors.lastname: Presles
authors.affiliation: EA 2992, Vascular Medicine Unit, CIC1001 Inserm, CHU de Montpellier, université Montpellier 1, 34295 cedex 5 Montpellier, France.
authors.forename: M
authors.initials: M
authors.lastname: Coupé
authors.affiliation: Department of Lymphology, Cognacq-Jay Hospital, 75015 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Vignes
authors.affiliation: Université François-Rabelais, 10, boulevard Tonnellé, BP 3223, 37032 Tours cedex 1, France.
authors.forename: L
authors.initials: L
authors.lastname: Vaillant
authors.affiliation: Service de médecine interne, Hôtel-Dieu, 44093 Nantes cedex 01, France.
authors.forename: D
authors.initials: D
authors.lastname: Eveno
authors.affiliation: Inserm, CIE3, unité de recherche clinique, innovation et pharmacologie, CHU de Saint-Étienne, 42055 Saint-Étienne, France; EA 3065, université Jean-Monnet, 42023 Saint-Étienne, France.
authors.forename: S
authors.initials: S
authors.lastname: Laporte
authors.affiliation: UMR 5558, CNRS Villeurbanne, université Claude-Bernard - Lyon 1, 69373 Lyon cedex 08, France.
authors.forename: A
authors.initials: A
authors.lastname: Leizorovicz
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000473:pathology; D001943:Breast Neoplasms / Q000601:surgery; D058128:Compression Bandages / Q000009:adverse effects; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000473:pathology; D008197:Lymph Node Excision / Q000009:adverse effects; D008209:Lymphedema / Q000209:etiology / Q000473:pathology / Q000534:rehabilitation / Q000628:therapy*; D008405:Massage; D008875:Middle Aged; D009929:Organ Size; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Bandage; Bandaging; Cancer; Compression; Decongestive therapy; Lymphedema; Lymphœdème; Traitement décongestif