Lymphatic Research and Biology

To determine whether a 4-day, twice-daily complete decongestive therapy (CDT) intervention effectively reduces limb volume in pediatric patients with primary and secondary lymphedema.

A retrospective cohort study was conducted using rehabilitation records of children aged 5–17 years from Camp Watchme, a North American summer camp providing lymphedema interventions.

Over 4 years, 38 unique campers contributed 66 records for analysis. The majority were female (68.42%), with a mean age of 9.30 ± 2.66 years. Lower extremity limb volume demonstrated statistically significant reductions across all 4 years (2021, p = 0.011; 2022, p = 0.030; 2023, p < 0.001; 2024, p < 0.001). Cumulative analysis of upper extremities (n = 16) also showed significant volume reduction (p = 0.042, r = 0.50). Daily measurement tracking (n = 43) indicated consistent percent volume decreases, with confidence intervals supporting a meaningful change for lower extremity limb volume differences across 4 years.

An intensive, short-duration CDT intervention significantly reduces limb volume in pediatric patients with lymphedema. Future research should explore long-term effects, optimize CDT protocols, and assess broader functional and psychosocial outcomes to enhance pediatric lymphedema management.

Lymphedema, a common side effect of breast cancer treatments, affects 20%–40% of patients. Ultrasound evaluation measures structural change as well as skin and subcutaneous tissue thicknesses to assess lymphedema severity. This study aimed to investigate the usefulness of ultrasound evaluation as an outcome measure of lymphedema in patients with breast cancer.

Thirty-one patients with unilateral breast cancer–related lymphedema were enrolled. Arm circumferences were measured at four points, as the Relative Metric Coefficient of Arm Lymphedema (RMCAL). The thickness of the skin and subcutaneous tissue was measured using ultrasound at four points of the upper arm and forearm, comparing both sides. Subcutaneous echogenicity grade (SEG) and subcutaneous echo-free space (SEFS) grade were assessed following the method described by Suehiro et al. Lymphoscintigraphy evaluated axillary lymph node uptake and dermal backflow. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast Cancer Module 23 (EORTC QLQ-BR23). Increase ratios of skin and subcutaneous tissue thickness, SEG, and SEFS were well correlated with RMCAL value. Additionally, the increase ratio of subcutaneous tissue was significantly different according to the abnormality of axillary lymph node uptake on lymphoscintigraphy. However, ultrasound parameters did not significantly associate with functional and symptom scales of EORTC QLQ-BR23.

Ultrasound parameters were well correlated with arm circumferences. Furthermore, subcutaneous tissue thickness on ultrasound was significantly related to lymphatic function assessed by lymphoscintigraphy.

Lower-limb lymphedema (LLL) secondary to gynecological cancer is a serious health condition that negatively affects physical activity (PA). We investigated the association between objectively measured PA and lymphedema markers in patients with LLL after gynecological cancer treatment.

This cross-sectional study included 56 patients (mean age: 62.0 years) with LLL attending a lymphedema center. The degree of lymphedema was evaluated based on lower-limb water content (extracellular water content/whole body water content: ECW/TBW). The amount and intensity of PA were measured using an accelerometer. Thirty-three patients (61.1%) with ECW/TBW ≥0.4 were older, had significantly more sedentary time, and spent lesser time on moderate-to-vigorous activity than patients with ECW/TBW <0.4 (p < 0.05). A generalized linear model using the rate of change in ECW/TBW showed an association with older age, longer time since cancer diagnosis, and lower activity level. The severity of subjective symptoms measured using a visual analog scale did not differ between patients with high and low ECW/TBW.

Patients with LLL spent approximately half of the time in sedentary behavior, with more severe cases exhibiting longer sedentary durations. In older patients who have a long-standing cancer diagnosis, medical professionals should evaluate their activity and self-care status in addition to evaluating LLL and use this information to provide individualized interventions.