{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:49:23Z","timestamp":1786978163403,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lymphedema (LE) is chronic swelling due to inadequate lymphatic function, which can occur after therapeutic lymph node dissection (TLND) for melanoma. At our institution, the risk of LE is 12% for axillary and 38% for ilioinguinal lymph node dissection. This study investigated LE rates in patients undergoing TLND with immediate lymphatic reconstruction (ILR) using lymphaticovenous anastomosis (LVA), a microsurgical technique aimed at preventing LE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with melanoma requiring TLND were recruited prospectively from the Tom Baker Cancer Center and were consented to undergo ILR at the time of their node dissection. Institutional ethics board approval was obtained (Ethics ID HREBA. cc\u201020\u20109426). This study was not a registered clinical trial; the ongoing randomized LYMbR trial (NCT05136079) is registered but does not include this cohort. The main objective was to assess the development of LE, which was defined as a 10% increase in postsurgical limb volume compared with the contralateral limb. In addition, participants completed the Lymphoedema Quality of Life Questionnaire (LYMQoL), a validated LE\u2010specific quality of life patient\u2010reported outcome measure (PROM) before surgery and at each 6\u2010month assessment, to assess for any changes in quality of life related to LE. A direct comparison was made to historical institutional rates of LE after TLND without ILR. Kaplan\u2010Meier analysis assessed overall survival and lymphedema\u2010free survival, while Mann\u2010Whitney U test compared quality of life between patients with and without lymphedema.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Between August 2020 and October 2022, 22 patients (14 men and 8 women) with a median age of 68 (range 43\u201380) were included in the study and underwent TLND for melanoma with ILR. 16 patients underwent ALND, and 6 patients underwent ILND with ILR. There were no complications directly related to the ILR part of the procedure. All disease was at least stage III. At a median follow\u2010up of 34 months (range: 0\u221251 months), three patients met the criteria for LE, one who underwent ALND and two ILND. Of these three patients, two had regional recurrence and one suffered from a DVT and a postoperative wound infection in the affected limb. LYMQoL scores were equal or better (p\u2009=\u2009NS) in patients without LE than those with LE across all domains except for mood: function (median IQR 1.0 vs 1.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.78), appearance (1.0 vs 1.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.19), symptom burden (1.1 vs 1.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.52), and mood (1.1 vs 1.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.87).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study aligns with other cohort studies demonstrating the usefulness of ILR in TLND patients with melanoma, which will be further examined in an ongoing randomized trial (LYMbR \u2010 NCT05136079).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70127","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T11:37:05Z","timestamp":1762342625000},"page":"46-53","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pilot Study of Immediate Lymphatic Reconstruction (ILR) During Lymph Node Dissection for Node\u2010Positive Melanoma: Feasibility, Safety, and Early Outcomes"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4267-9363","authenticated-orcid":false,"given":"Eva Lindell","family":"Jonsson","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery University of Calgary Calgary Alberta Canada"},{"name":"Division of Plastic Surgery and Maxillofacial Surgery Uppsala University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. K.","family":"Fraser Hill","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marielle","family":"Saayman","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spencer","family":"Yakaback","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Golpira Elmi","family":"Assadzadeh","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Calgary Calgary Alberta Canada"},{"name":"Division of Plastic Surgery and Maxillofacial Surgery Uppsala University Hospital Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. J.","family":"Gregory McKinnon","sequence":"additional","affiliation":[{"name":"Division of Surgical Oncology Arthur J.E. Child Comprehensive Cancer Centre Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Temple\u2010Oberle","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljad244"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613210"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-01851-x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2020.01.146"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-021-00276-y"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.GOX.0000584644.19057.24"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-020-02455-z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.41.8574"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29080446"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22254"},{"key":"e_1_2_9_12_1","first-page":"26","article-title":"A Quality of Life Measure for Limb Lymphoedema (LYMQOL)","volume":"5","author":"Keeley V.","year":"2010","journal-title":"J Lymphoedema"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30040306"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/83.2.134"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2023.03.019"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.02306"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33483"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2021.02.013"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318307"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3401829"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29080446"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002169"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-08086-0"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21409"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005385"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2022.40.16_suppl.9557"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000003431"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2021.02.009"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2024.103678"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2024.103678"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.70127","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T21:20:02Z","timestamp":1767043202000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.70127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1002\/jso.70127"],"URL":"https:\/\/doi.org\/10.1002\/jso.70127","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]},"assertion":[{"value":"2025-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}