Lymphedema outcomes in patients with head and neck cancer.
OBJECTIVE
We sought to describe the presentation of external head and neck lymphedema in patients treated for head and neck cancer and to examine their initial responses to complete decongestive therapy.


METHODS
Case series with chart review.


METHODS
MD Anderson Cancer Center, Houston, Texas.


METHODS
The charts of patients who were evaluated for head and neck cancer at MD Anderson Cancer Center after treatment (January 2007-January 2013) were retrospectively reviewed. Response to complete decongestive therapy was evaluated per changes in lymphedema severity rating or surface tape measures. Predictors of therapy response were examined on the basis of regression models.


RESULTS
The cases of 1202 patients were evaluated. Most patients (62%) had soft reversible pitting edema (MD Anderson Cancer Center stage 1b). Treatment response was evaluated for 733 patients; 439 (60%) improved after complete decongestive therapy. Treatment adherence independently predicted complete decongestive therapy response (P < .001).


CONCLUSIONS
These data support the effectiveness of a head and neck cancer-specific regimen of lymphedema therapy for cancer patients with external head and neck lymphedema. Our findings suggest that head and neck lymphedema is distinct from lymphedema that affects other sites, thus requiring adaptations in traditional methods of management and measurement.
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
Brad G
BG
Smith
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
Katherine A
KA
Hutcheson
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
Leila G
LG
Little
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
Roman J
RJ
Skoracki
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
David I
DI
Rosenthal
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
Stephen Y
SY
Lai
Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center Houston, Texas 77030 USA.
Jan S
JS
Lewin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008209:Lymphedema / Q000209:etiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013781:Texas; D016896:Treatment Outcome
cancer; head and neck; lymphedema; manual lymphatic drainage; treatment