Comparative Efficacy of 3L and 2L Integrated Techniques for Gynecologic Cancer-related Lower Extremity Lymphedema: a Retrospective Study

Zunyi Medical College

Status: Completed

Conditions: Lymphedema; Gynecologic Cancer-related Lower Extremity Lymphedema

Treatments: Procedure: VLNT（Vascularized Lymph Node Transfer）; Procedure: LVA（Lymphaticovenular Anastomosis）; Procedure: LS（Liposuction）

Study type: Observational

Funder types: Other

Identifiers

NCT06920732

KLLY-2024-093

Details and patient eligibility

About

The goal of this retrospective study is to evaluate the long-term efficacy of 3L versus 2L integrated techniques in patients with gynecologic cancer-related lower extremity lymphedema (GCR-LEL). The main research question is:

Do 3L integrated techniques provide superior long-term outcomes in reducing lower extremity lymphedema compared to 2L techniques in patients with GCR-LEL?

Medical records of patients who have received either 3L or 2L integrated interventions as part of their routine clinical management for GCR-LEL were reviewed and analyzed to assess treatment outcomes over an extended follow-up period.

Enrollment: 125 patients

Sex: Female

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. The patients diagnosed with gynecological cancer-related lymphedema by clinical examination are classified by the International Lymphedema Society (ISL) guidelines as Stage II to III.
2. .Aged 18-90 years.

Exclusion criteria

1. Lactation, for patients with pregnancy;
2. Serious heart, lung, liver, kidney disease, as well as the history of tumor patients;
3. Disease history is less than 3 months;
4. In patients with mental illness;
5. Immunodeficiency patients.

Trial design

125 participants in 3 patient groups

VLNT + LVA + LS (Vascularized Lymph Node Transfer + Lymphaticovenular Anastomosis + Liposuction)

Description:

This triple-modality intervention combines physiologic and debulking techniques. VLNT is performed to restore lymphatic function by transferring vascularized lymph nodes to the affected limb. LVA further facilitates lymphatic drainage by creating anastomoses between lymphatic vessels and nearby venules. LS is conducted to remove excess fibroadipose tissue and reduce limb volume. This comprehensive approach is hypothesized to provide synergistic and sustained benefits in severe or refractory lymphedema cases.

Treatment:

Procedure: LS（Liposuction）

Procedure: LVA（Lymphaticovenular Anastomosis）

Procedure: VLNT（Vascularized Lymph Node Transfer）

VLNT + LS (Vascularized Lymph Node Transfer + Liposuction)

Description:

This dual-modality intervention focuses on both physiologic restoration and volume reduction. VLNT is used to reconstruct lymphatic drainage pathways, while LS addresses tissue hypertrophy. This combination is selected for patients with poor lymphatic function and substantial limb volume increase, in whom LVA is not feasible due to lack of functional lymphatic vessels.

Treatment:

Procedure: LS（Liposuction）

Procedure: VLNT（Vascularized Lymph Node Transfer）

LVA + LS (Lymphaticovenular Anastomosis + Liposuction)

Description:

This approach combines a minimally invasive physiologic procedure (LVA) with LS. LVA promotes lymph flow by bypassing obstructed lymphatic channels, while LS removes accumulated fibrofatty tissue. It is suitable for patients with partially preserved lymphatic function and moderate limb volume increase.

Treatment:

Procedure: LS（Liposuction）

Procedure: LVA（Lymphaticovenular Anastomosis）