Complex lymphatic malformations in pediatrics: a review of treatment options

Pessanha, Inês; Bravo, Mariana; Piedade, Cláudia; Lopes, Maria Francelina

doi:10.23736/s2724-5276.20.06037-5

Cited by 5 publications

(4 citation statements)

References 63 publications

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“…To our knowledge, there is sparse studies that have explored prognostic factors of sclerotherapy in LMs and a predictive nomogram prediction model is absence at present; meanwhile, most researches have focused on the e cacy of each sclerosing agents [16][17][18]. In addition, many studies only compared the e cacy of various sclerosants in children with LMs [19][20]. However, researches mainly focused on the prognostic variables for LMs with sclerotherapy were relative sparse.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting sclerotherapy response for treatment of lymphatic malformations in children

Wu¹,

Zou²,

Fu³

et al. 2022

Preprint

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Purpose In this manuscript, we purposed to identify the prognostic factors for treatment of lymphatic malformations in children using polidocanol foam combined with pingyangmycin and to construct nomogram for predicting sclerotherapy response.Methods A retrospective analysis of 77 children having LMs underwent sclerotherapy using polidocanol foam combined with pingyangmycin under ultrasound display from January 2017 to April 2020 was done. The clinical response was graded as excellent (≥90%), good (≥50%, <90%), and poor (<50%). More than 50% was considered as acceptable response. Prognostic factors were identified by Pearson’s chi-square or Fisher’s exact test and multivariable logistic regression model was used to construct a nomogram to predict sclerotherapy response. The discrimination and calibration of nomogram were verified through the receiver operating characteristic cure and calibration plots.Results The mean number of treatment sessions was 3.1 (range, 1-6). Among 77 patients, 58 patients (75.3%) had excellent response to treatment (≥90%) and 68 patients (88.3%) had an acceptable response (≥50%, <90%). Clinical disfigurement (P = 0.014), skin discoloration (P = 0.040), morphological subtype (P < 0.001) and extent of the lesion (P < 0.001) correlated with clinical response to sclerotherapy in LMs. Sclerotherapy response was predicted through nomogram constructed in this study, which shows good calibration and discrimination. Also, focal lesion and macrocystic or mixed morphological subtype lesion were seen more often in lower number of treatment sessions among the patients with excellent response.Conclusions Acceptable response to sclerotherapy using polidocanol foam combined with pingyangmycin was achieved in majority of LMs in children with extremely low complication rates. Nomogram basing on the prognostic factors of sclerotherapy response for LMs in children was showed to possess an excellent performance to predicate the probability of LMs sclerotherapy response.

show abstract

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting sclerotherapy response for treatment of lymphatic malformations in children

Wu¹,

Zou²,

Fu³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…To our knowledge, there are sparse studies that have explored prognostic factors of sclerotherapy in LMs and a predictive nomogram prediction model is absence at present; meanwhile, most researches have focused on the efficacy of each sclerosing agents [16][17][18]. In addition, many studies only compared the efficacy of various sclerosants in children with LMs [19,20]. However, researches mainly focused on the prognostic variables for LMs with sclerotherapy were relative sparse.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting sclerotherapy response for treatment of lymphatic malformations in children

Zou

et al. 2022

Eur J Med Res

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Purpose In this manuscript, we purposed to identify the prognostic factors for treatment of lymphatic malformations in children using polidocanol foam combined with pingyangmycin and to construct nomogram for predicting sclerotherapy response. Methods A retrospective analysis of 77 children having LMs who underwent sclerotherapy using polidocanol foam combined with pingyangmycin under ultrasound display from January 2017 to April 2020 was done. The clinical response was graded as excellent (≥ 90%), good (≥ 50%, < 90%), and poor (< 50%). More than 50% was considered as acceptable response. Prognostic factors were identified by Pearson’s Chi-square or Fisher’s exact test and multivariable logistic regression model was used to construct a nomogram to predict sclerotherapy response. The discrimination and calibration of nomogram were verified through the receiver operating characteristic cure and calibration plots. Results The mean number of treatment sessions was 3.1 (range, 1–6). Among 77 patients, 58 patients (75.3%) had excellent response to treatment (≥ 90%) and 68 patients (88.3%) had an acceptable response (≥ 50%, < 90%). Clinical disfigurement (P = 0.014), skin discoloration (P = 0.040), morphological subtype (P < 0.001) and extent of the lesion (P < 0.001) correlated with clinical response to sclerotherapy in LMs. Sclerotherapy response was predicted through nomogram constructed in this study, which shows good calibration and discrimination. Also, focal lesion and macrocystic or mixed morphological subtype lesion were seen more often in lower number of treatment sessions among the patients with excellent response. Conclusions An acceptable response to sclerotherapy using polidocanol foam combined with pingyangmycin was achieved in majority of LMs in children with extremely low complication rates. Nomogram based on the prognostic factors of sclerotherapy response for LMs in children was shown to possess an excellent performance to predict the probability of LMs sclerotherapy response.

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“…Часто лимфатические образования имеют сложную анатомическую локализацию, прилегают к крупным сосу-дисто-нервным пучкам. Хирургическое лечение отличается частыми рецидивами и риском развития тяжёлых осложнений [27,28]. Кроме того, поскольку этиология ЛМФ остаётся недостаточно изученной, отсутствует общепризнанная патогенетическая терапия.…”

Section: Introductionunclassified

Diagnosis and treatment of lymphatic malformations: experience of the surgical department for newborns and infants

Gurskaya,

Sulavko,

Bayazitov

et al. 2023

RPJ

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Introduction. Lymphatic malformations (LM) are a congenital pathology of lymphatic vessels that arose during embryogenesis. The relevance of the research topic is due to the rarity, variety of clinical manifestations, and the lack of clinical recommendations for treatment. Aim. To evaluate our experience of surgical and conservative treatment of LM in the surgical department for newborns and infants. Materials and methods. We performed a retrospective analysis of infants with various forms of LM treated at our department from 2017 to 2022. The study protocol was approved by the local ethics committee. The patients’ parents gave written voluntary informed consent to participate in the study. Results. Depending on the form of a LM, the infants underwent conservative therapy, sclerotherapy or surgical resection of the LM. Conclusions. Genetic tests for the spectrum of overgrowth syndromes are necessary for all LM patients to clarify the etiology of the process, prevent recurrence and complications.

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Complex lymphatic malformations in pediatrics: a review of treatment options

Cited by 5 publications

References 63 publications

A nomogram for predicting sclerotherapy response for treatment of lymphatic malformations in children

A nomogram for predicting sclerotherapy response for treatment of lymphatic malformations in children

A nomogram for predicting sclerotherapy response for treatment of lymphatic malformations in children

Diagnosis and treatment of lymphatic malformations: experience of the surgical department for newborns and infants

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