Treatment approaches and outcomes of a head and neck lymphedema service at an Australian comprehensive cancer center

Background: Patients treated for head and neck cancer are at high risk of developing head and neck lymphedema (HNL). We describe outcomes of HNL management at an Australian institution from 2018 to 2020. Methods: Electronic records from Chris O'Brien Lifehouse were retrospectively reviewed from January 1, 2018 to December 31, 2020. Objective changes in HNL were assessed using The M. D. Anderson Cancer Center (MDACC) HNL rating scale and Assessment of Lymphedema of the Head and Neck (ALOHA). Results: Among the 100 patients referred for management of HNL, surgery was the most frequent treatment modality (80%; 70% with neck dissection) and 69% underwent radiotherapy. Manual lymphatic drainage (MLD) was most often prescribed (96%), followed by self-MLD (93%). Small but significant improvements in ALOHA measurements were observed for 50 patients (50%). Only 5/29 (17%) patients had post-treatment improvements on the MDACC scale. Conclusions: Standardized, prospective measurement of treatment approaches and outcomes is needed to further evaluate the service.

Automated summary

This study retrospectively analyzed the outcomes of head and neck lymphedema management at an Australian institution using the MDACC and ALOHA assessments. The results showed that surgery and manual lymphatic drainage were the most common treatment modalities. Some patients experienced small but significant improvements according to the ALOHA assessment, however, the proportion of patients with post-treatment improvements on the MDACC scale was low.