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ISSN 1561-3186 (Electronic)

2015, Number 2

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Rev Acta Médica 2015; 16 (2)

Prognosis factors for postmastectomy lymphedema: systemic review and meta-analysis in chosen cohorts

Díaz HO, Musenden OE, García LML, Peguero BY, Hidalgo CT

Language: Spanish
References: 40
Page:
PDF size: 402.44 Kb.


ABSTRACT

Introduction: women who survive after breast cancer treatment may suffer from systemic and localized complications, among them lymphedema. Numerous publications analyze the factors contributing to edema formation, its prognosis and how to treat it.
Methods: on the base of international scientific evidence five prognosis factor were chosen by systemic review and meta-analysis carried out in prospective cohort studies, with the aim at identifying and assessing them. Information search was performed by PubMed-MEDLINE, Cochrane and Lilacs. Qualitative analysis was carried out with analyzing programs according the hierarchy of evidence methodology. Quantitative analysis was performed by heterogeneity tests DerSimonian and Laird, and by weighted estimation of the size of the combined randomized effect with the confidence intervals at 95% with their respective funnelplot.
Results: among the 217 publications, 11 were chosen (5.1%). Four out of five prognosis factors obtained heterogeneous results with randomized effect (axillary dissection, radiotherapy, resected ganglia and obesity) and one homogenous fixed effect (lymphangitis), all of it without publishing bias.
Conclusions: dissection of the axillary region, the amount of lymphatic ganglia extracted, the axillary radiotherapy itself, relapsed lymphangitis crisis and obesity are the prognosis factor contributing most to the development of lymphedema after breast cancer surgery. Everything seems to indicate that the surviving women´s longevity will potentially impact the number of mastectomized women.


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