{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T15:31:28Z","timestamp":1785511888527,"version":"3.56.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,25]],"date-time":"2019-12-25T00:00:00Z","timestamp":1577232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012553","name":"Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CORPG3J0221"],"award-info":[{"award-number":["CORPG3J0221"]}],"id":[{"id":"10.13039\/100012553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study was to investigate the lymphoscintigraphy findings for the diagnosis and severity in unilateral gynecological cancer\u2013related lymphedema (GCRL) and to correlate lymphoscintigraphy stages with the clinical findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with unilateral GCRL who underwent lymphoscintigraphy were staged using the presence of ileo\u2010inguinal lymph nodes, distal\u2010lymphatic ducts, and dermal backflow findings. Taiwan Lymphoscintigraphy Staging (TLS) was divided into three patterns and seven stages: normal drainage (L\u20100); partial obstruction (P\u20101, P\u20102, and P\u20103); and total obstruction (T4, T\u20105, and T\u20106). Correlations between clinical lymphedema severity and TLS were evaluated using analysis of variance and multivariable linear regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 141 patients with unilateral GCRL were divided as follows: 6 (4.3%) in normal drainage, 56 (39.7%) in partial\u2010obstruction, and 79 (56%) in total obstruction. Cellulitis episodes, circumferential difference, and computed tomography (CT) volumetric difference were shown to be statistically different between TLS stages (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001 for all). Total obstruction stages were the most significant factors associated with the severity of circumferential difference (<jats:italic>\u03b2<\/jats:italic>\u2009=\u200919.72, 25.54, 32.42, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05) and CT volumetric difference (<jats:italic>\u03b2<\/jats:italic>\u2009=\u200936.04, 45.12, 52.78, respectively; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Total lymphatic obstruction was present in 56% of unilateral GCGL. Lymphoscintigraphy stages were statistically correlated with episodes of cellulitis, circumferential difference and CT volumetric difference in unilateral GCRL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.25817","type":"journal-article","created":{"date-parts":[[2019,12,26]],"date-time":"2019-12-26T06:10:47Z","timestamp":1577340647000},"page":"422-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Staging and clinical correlations of lymphoscintigraphy for unilateral gynecological cancer\u2013related lymphedema"],"prefix":"10.1002","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4911-9523","authenticated-orcid":false,"given":"Marco","family":"Pappalardo","sequence":"first","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital, College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences University of Palermo  Palermo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chieh","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia A.","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang\u2010Fu","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Allergy, and Immunology Chang Gung Memorial Hospital  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5286-034X","authenticated-orcid":false,"given":"Chia\u2010Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-2959","authenticated-orcid":false,"given":"Ming\u2010Huei","family":"Cheng","sequence":"additional","affiliation":[{"name":"Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital, College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,25]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"51","article-title":"The diagnosis and treatment of peripheral lymphedema: 2009 consensus document of the International Society of Lymphology","volume":"42","author":"International Society of Lymphology","year":"2009","journal-title":"Lymphology"},{"issue":"3","key":"e_1_2_10_3_1","first-page":"150","article-title":"Risk factors for cellulitis in patients with lymphedema: a case\u2010controlled study","volume":"46","author":"Teerachaisakul M","year":"2013","journal-title":"Lymphology"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0114597"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1048-891X.2004.14524.x"},{"key":"e_1_2_10_6_1","unstructured":"U. 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