Comprehensive scoring of 99mTc-SC lymphoscintigraphy for predicting the prognosis of secondary lower limb lymphedema treatment after gynecological cancer surgery
Objective:Preliminary construction of a comprehensive scoring system based on qualitative indicators of 99mTc-SC lymphoscintigraphy to explore the predictive value of 99mTc-SC lymphoscintigraphy in assessing the efficacy of comprehensive decongestive therapy for secondary lower limb lymphedema following gynecological cancer surgery.Methods:A retrospective analysis was conducted on the data of 48 gynecological cancer patients at the First Affiliated Hospital of Sun Yat-sen University from January 2018 to March 2023 who developed secondary lymphedema following surgical procedures and received comprehensive decongestive therapy.Subsequently,the patients were stratified into effective(n=28)and ineffective treatment(n=20)groups based on predefined research criteria,with both clinical information and 99mTc-SC lymphography data collected.The qualitative indicators of lymphography primarily encompassed:① visibility of main lymphatic vessels'uptake pattern;② identification of obstruction site in the pelvis or knee joint;③ classification of subcutaneous soft tissue drainage type in lower limbs;(4)assessment of collateral lymphatic circulation presence.Results:There was a statistical difference in the delayed phase of lower limb lymphatic drainage and comprehensive score between the two groups(P＜0.05).The predictive performance of the comprehensive score is significantly superior to that of the single qualitative indicator of lymphoscintigraphy.The sensitivity,specificity,and accuracy of prognostic assessment based on the comprehensive scoring system derived from nuclear lymphatic imaging were 96.4％,85.0％,and 91.7％,respectively.Conclusion:Preoperative lymphoscintigraphy may be valuable for predicting the response to treatment of gynecologic cancer-related lymphedema following comprehensive decongestive therapy.The late-stage soft tissue bypass classification and comprehensive score serves as the primary independent predictor,and a scoring system that integrates multiple qualitative features can significantly enhance the sensitivity and accuracy of prognosis prediction.
lymphatic imaginggynecologic cancerslymphedemacomprehensive scoring system
NETL
NSTL
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