Octreotide Can Control Lymphorrhea after Axillary Node Dissection in Mastectomy Operations

Mahmoud, S. A.; Abdel-Elah, Kamal; Eldesoky, Abdel-Hamid; El-Awady, Saleh

doi:10.1111/j.1524-4741.2006.00380.x

Cited by 14 publications

(14 citation statements)

References 5 publications

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“…Differences between the results reported by Carcoforo [ 10 ] and Mahmoud [ 11 ] and our results could be partially explained. First, the clinical practices were different.…”

Section: Discussioncontrasting

confidence: 99%

“…Another more recent article by Mahmoud et al . [ 11 ] showed the same beneficial effects on the mean daily drainage volume (104 vs. 145 ml, p = 0.0001), the total duration of drainage (12.7 vs. 25 days, p = 0.0001) and the need for postoperative aspiration of lymphoceles (40 vs. 90%, p = 0.0001).…”

Section: Discussionmentioning

confidence: 76%

“…Octreotide, a somatostatin analog, has been successfully used for the medical management of postoperative gastrointestinal and pancreatic fistulae [ 9 ]. Two recent studies have demonstrated its value in reducing lymphoceles following ALNDs performed as part of breast cancer surgery [ 10 , 11 ]. However, one recent study, published during our study, did not identify any significant reduction of lymphorrhea using lanreotide, another somatostatin analogue [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of the Effects of Pasireotide LAR Administration on Lymphocele Prevention after Axillary Node Dissection for Breast Cancer: Results of a Randomized Non-Comparative Phase 2 Study

et al. 2016

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ObjectiveThe aim of this study was to assess the efficacy (response rate centered on 80%) of a somatostatin analog with high affinity for 4 somatostatin receptors in reducing the postoperative incidence of symptomatic lymphocele formation following total mastectomy with axillary lymph node dissection.SettingThis prospective, double-blind, randomised, placebo-controlled, phase 2 trial was conducted in two secondary care centres.ParticipantsAll female patients for whom mastectomy and axillary lymph node dissection were indicated were eligible for the study, including patients who had received neo-adjuvant chemotherapy. Main exclusion criteria were related to diabetes, cardiac insufficiency, disorder of cardiac conduction or hepatic failure.InterventionsPatients were randomised to receive one injection of either prolonged-release pasireotide 60 mg or placebo (physiological serum), which were administered intramuscularly 7 to 10 days before the scheduled surgery. The study was conducted in a double-blind manner.Primary and Secondary Outcome MeasuresThe primary outcome measure was the percentage of patients who did not develop post-operative axillary symptomatic lymphoceles during the 2 postoperative months. Secondary endpoints were the total quantity of lymph drained, duration and daily volume of drainage and aspirated volumes of lymph.ResultsNinety-one patients were randomised. Ninety patients were evaluable: 42 patients received pasireotide, and 48 patients received placebo. The mean estimated response rate were 62.4% (95% Credibility Interval [CrI]: 48.6%-75.3%) in the treatment group and 50.2% (95% CrI: 37.6%-62.8%) in the placebo group. Overall safety was comparable across groups, and one serious adverse event occurred. In the treatment group, one patient with known insulin-depe*ndent diabetes required hospitalization for hyperglycaemia.ConclusionsWith this phase 2 preliminary study, even if our results indicate a trend towards a reduction in symptomatic lymphocele, pre-operative injection of pasireotide failed to achieve a response rate centered on 80%. Pharmacokinetics analysis suggests that effect of pasireotide could be optimised.Trial RegistrationClinicalTrials.gov NCT01356862

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“…Differences between the results reported by Carcoforo [ 10 ] and Mahmoud [ 11 ] and our results could be partially explained. First, the clinical practices were different.…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of the Effects of Pasireotide LAR Administration on Lymphocele Prevention after Axillary Node Dissection for Breast Cancer: Results of a Randomized Non-Comparative Phase 2 Study

et al. 2016

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“…For patients with lymphorrhea (59) or large, recurrent chylous effusions, the systemic administration of somatostatin or its synthetic analog, octreotide, has been shown to be therapeutically advantageous (60). This approach may be particularly useful when there is evidence of thoracic duct or superior vena caval obstruction.…”

Section: Treatment Of Lymphatic Vascular Diseasesmentioning

confidence: 96%

Diagnosis and Management of Lymphatic Vascular Disease

Rockson

2008

Journal of the American College of Cardiology

148

110

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The lymphatic vasculature is comprised of a network of vessels that is essential both to fluid homeostasis and to the mediation of regional immune responses. In health, the lymphatic vasculature possesses the requisite transport capacity to accommodate the fluid load placed upon it. The most readily recognizable attribute of lymphatic vascular incompetence is the presence of the characteristic swelling of tissues, called lymphedema, which arises as a consequence of insufficient lymph transport. The diagnosis of lymphatic vascular disease relies heavily upon the physical examination. If the diagnosis remains in question, the presence of lymphatic vascular insufficiency can be ascertained through imaging, including indirect radionuclide lymphoscintigraphy. Beyond lymphoscintigraphy, clinically-relevant imaging modalities include magnetic resonance imaging and computerized axial tomography. The state-of-the-art therapeutic approach to lymphatic edema relies upon physiotherapeutic techniques. Complex decongestive physiotherapy is an empirically-derived, effective, multicomponent technique designed to reduce limb volume and maintain the health of the skin and supporting structures. The application of pharmacological therapies has been notably absent from the management strategies for lymphatic vascular insufficiency states. In general, drug-based approaches have been controversial at best. Surgical approaches to improve lymphatic flow through vascular reanastomosis have been, in large part, unsuccessful, but controlled liposuction affords lasting benefit in selected patients. In the future, specifically engineered molecular therapeutics may be designed to facilitate the controlled regrowth of damaged, dysfunctional, or obliterated lymphatic vasculature in order to circumvent or mitigate the vascular insufficiency that leads to edema and tissue destruction.

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“…Il apparaît donc intéressant de se pencher sur l'effet potentiel de la somatostatine sur ces tumeurs. mL, p = 0,0001), sur la durée totale de drainage (12,7 vs 25 jours, p = 0,0001), ainsi que sur la nécessité de ponction des lymphocèles post opératoires (90 vs 40 %, p = 0,0001) [19].…”

Section: La Somatostatine Dans Le Cancer Du Seinunclassified

Somatostatin in breast cancer

Frati

Antoine²,

Rodenas³

et al. 2011

Annales De Biologie Clinique

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La somatostatine est une hormone produite, chez l'homme, principalement au niveau de l'hypothalamus. Elle joue de nombreux rôles de régulation hormonale par le biais de récepteurs spécifiques dans l'organisme. Elle possède également deux actions intéressantes, à savoir une activité anti-sécrétoire, principalement sur le système gastro-intestinal, et une action anti-prolifératrice sur les cellules tumorales. De nombreux analogues synthétiques, plus stables que la somatostatine naturelle, ont donc été développés et ceux-ci sont déjà utilisés en pratique courante dans la chirurgie digestive notamment pour la prise en charge de fistule digestive post opératoire. Par ailleurs, le développement d'anticorps polyclonaux spécifiques a permis d'identifier cinq sous-types de récepteurs de la somatostatine et d'étudier leur distribution dans différents types cellulaires. La présence des différents sous-types de récepteurs de la somatostatine dans les cellules tumorales du sein a ainsi été démontrée. Le but de cette revue est de rapporter le rôle potentiel anti-tumoral des analogues de la somatostatine dans la prise en charge des cancers du sein, son utilisation possible préventive dans la survenue de lymphocèles post opératoires et son usage en imagerie pour permettre une détection plus précoce des lésions du sein.

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Octreotide Can Control Lymphorrhea after Axillary Node Dissection in Mastectomy Operations

Cited by 14 publications

References 5 publications

Evaluation of the Effects of Pasireotide LAR Administration on Lymphocele Prevention after Axillary Node Dissection for Breast Cancer: Results of a Randomized Non-Comparative Phase 2 Study

Evaluation of the Effects of Pasireotide LAR Administration on Lymphocele Prevention after Axillary Node Dissection for Breast Cancer: Results of a Randomized Non-Comparative Phase 2 Study

Diagnosis and Management of Lymphatic Vascular Disease

Somatostatin in breast cancer

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