LYMPHSCINTIGRAPHY PREDICTS RESPONSE TO COMPLEX PHYSICAL THERAPY IN PATIENTS WITH EARLY STAGE EXTREMITY LYMPHEDEMA

Abstract

We investigated whether baselinelymphscintigraphic findings can predict longtermresponse to complex physical therapy(CPT) in patients with early stage extremitylymphedema. Twenty patients with unilateralextremity lymphedema of clinical stage I or IIunderwent CPT after baseline lymphscintigraphy.Therapeutic responses (good vs. poor)were evaluated at 1 year post-CPT based onchanges in skin status and subjectivesymptoms, and percent volume reductions andcompared with clinical factors and lymphscintigraphicfindings. Eleven patients showedgood response to CPT with significant volumereduction of edematous extremities, and nosignificant volume reduction was observed inthe remaining 9. Patients with good or poorresponses to CPT showed no significantdifferences in terms of clinical variables.However, significant differences were observedbetween the lymphscintigraphic findings ofthese patients. More specifically, a lymphscintigraphicfinding of main lymphatic vesselswithout collateral lymphatic vessels was thebest predictor for a good response to CPT; thesensitivity, specificity and accuracy of thislymphscintigraphic finding is 91% (10/11),100% (9/9) and 95% (19/20), respectively. Inpatients with unilateral extremity lymphedemaof early stage, baseline lymphscintigraphy mayusefully predict long-term response to CPT.