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Comparison of Staging Systems to Assess Lymphedema Caused by Cancer Therapies, Lymphatic Filariasis, and Podoconiosis.

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Douglass, Janet and Kelly-Hope, Louise ORCID: https://orcid.org/0000-0002-3330-7629 (2019) 'Comparison of Staging Systems to Assess Lymphedema Caused by Cancer Therapies, Lymphatic Filariasis, and Podoconiosis.'. Lymphatic Research and Biology. (In Press)

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Abstract

BACKGROUND

Lymphedema is a disease of the skin and subcutaneous tissue resulting from a disturbance in lymph flow. Anyone can be affected, and causes include cancer therapy when lymph nodes are removed or irradiated, the parasitic disease lymphatic filariasis, and damage caused by exposure to irritant soils known as podoconiosis. Manifest lymphedema is progressive and a major contributor to disability, stigma, and social isolation for affected people. Although the pathogenesis of connective tissue changes in lymphedema will follow a similar course regardless of the disease of causation, several systems are used to stage progression. Disparity in these staging systems leads to inconsistency in reporting of the severity of lymphedema and prevents meta-analysis of research results. In the global health environment, integrated morbidity management for chronic illness is essential to meet the needs of affected people and to be sustainable for health care systems. Clinical descriptors for staging criteria within each system may assist clinicians in assessment and provide a format for consistency in reporting by lymphedema researchers.

METHODS AND RESULTS

Lymphedema staging systems used in oncology, filariasis, and podoconiosis settings were reviewed and the assessment techniques, diagnostic procedures, and clinical observations used by each system are described. The most commonly used staging systems are compared to identify similarities, and a matrix approach to lymphedema staging is proposed.

CONCLUSION

A universal staging system would contribute to more consistent reporting of research on and clinical management of lymphedema arising from multiple causes.

Item Type: Article
Subjects: QV Pharmacology > QV 56 Adverse effects (General)
QZ Pathology > Neoplasms. Cysts > QZ 200 Neoplasms. Cysts (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
WH Hemic and Lymphatic Systems > Lymphatic System > WH 700 Lymphatic system. Lymphatic diseases (General)
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1089/lrb.2018.0063
Depositing User: Stacy Murtagh
Date Deposited: 13 Mar 2019 15:45
Last Modified: 11 Apr 2019 14:16
URI: http://archive.lstmed.ac.uk/id/eprint/10343

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