Evidence map›Paper›PMID 39961719›Full record

ArticleBMJ open2025

The LYMPH trial: comparing microsurgical with conservative treatment for chronic breast cancer-associated lymphoedema - study protocol of a pragmatic randomised international multicentre superiority trial.

Elisabeth A Kappos, Yvonne Haas, Alexandra Schulz, Florian Peters, Shakuntala Savanthrapadian, Julia Stoffel, Maria C Katapodi, Rosine Mucklow, Benedict Kaiser, Alexander Haumer and 59 more

Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05890677 (The LYMPH Trial - Comparing Microsurgical With Conservative Treatment of Chronic Breast Cancer Associated Lymphedema), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05890677 narecruitingnot on this map

The LYMPH Trial - Comparing Microsurgical With Conservative Treatment of Chronic Breast Cancer Associated Lymphedema: Study Protocol of a Pragmatic Randomized International Multicentre Superiority Trial

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2023 to 2036Enrolled280ConditionsLymphedema, Breast CancerArmsSurgical Intervention, Conservative Complex Physical Decongestion Therapy
3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

69 authors.

Elisabeth A KapposDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland elisabeth.kappos@usb.ch.ORCID http://orcid.org/0000-0003-4057-1951
Yvonne HaasDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0009-0001-4940-452X
Alexandra SchulzUniversity of Basel, Basel, Switzerland.
Florian PetersUniversity of Basel, Basel, Switzerland.
Shakuntala SavanthrapadianUniversity of Basel, Basel, Switzerland.
Julia StoffelDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Maria C KatapodiDepartment of Clinical Research, Founding Member Patient Advocacy Group Oncoplastic Breast Consortium, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-3903-3750
Rosine MucklowPatient Advocacy Group, Oncoplastic Breast Consortium, Basel, Switzerland.
Benedict KaiserDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Alexander HaumerDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Stephanie EtterDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Marco CattaneoDepartment of Clinical Research, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-6610-8431
Daniel StaubDepartment of Angiology, University Hospital Basel, Basel, Switzerland.
Karin RibiQuality of Life Office, International Breast Cancer Study Group, A Division of ETOP IBCSG Partners Foundation, Careum, Bern, Switzerland.
Jane ShawPatient Advocacy Group, Oncoplastic Breast Consortium, Basel, Switzerland.
Tristan M HandschinDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Steffen EisenhardtDepartment of Plastic and Hand Surgery, University Hospital Freiburg, Freiburg, Germany.
Giuseppe ViscontiDepartment of Woman and Child Health and Public Health, Division of Plastic Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Gianluca FranceschiniDepartment of Woman, Child Health and Public Health, Division of Breast Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Lorenzo ScardinaDepartment of Woman, Child Health and Public Health, Division of Breast Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Benedetto LongoDepartment of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Roma, Italy.
Marcus VetterDepartment of Oncology, Cantonal Hospital Basel-Landschaft, Liestal, Switzerland.
Khalil ZamanDepartment of Medical Oncology, Lausanne University Hospital, Lausanne, Switzerland.
Jan A PlockDepartment of Plastic Surgery and Hand Surgery, Cantonal Hospital Aarau, Aarau, Switzerland.
Mario ScaglioniDepartment of Hand and Plastic Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.
Eduardo G GonzalezDivision of Oncoplastic Surgery, Buenos Aires British Hospital, University of Buenos Aires, Instituto de Oncología Angel H Roffo, Buenos Aires, Argentina.
Sergio D QuildrianDivision of Oncoplastic Surgery, Buenos Aires British Hospital, University of Buenos Aires, Instituto de Oncología Angel H Roffo, Buenos Aires, Argentina.
Gunther FelmererDepartment of Trauma Surgery, Orthopedic Surgery and Plastic Surgery, University Medical Center Göttingen, Gottingen, Germany.
Babak J MehraraDepartment of Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
Jaume Masia AyalaDepartment of Plastic Surgery, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Gemma PonsDepartment of Plastic Surgery, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Daniel F KalbermattenDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.
Justin M SacksDivision of Plastic and Reconstructive Surgery, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USA.
Martin HalleDepartment of Reconstructive Plastic Surgery, Karolinska University Hospital, Stockholm, Sweden.
Maximillian V MunteanDepartment of Plastic Surgery, Institute of Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Erin M TaylorDivision of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Maria ManiDepartment of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
Florian J JungDepartment of Plastic and Hand Surgery, Cantonal Hospital Winterthur, Winterthur, Switzerland.
Pietro G di SummaDepartment of Plastic and Hand Surgery, CHUV, Lausanne, Switzerland.
Efterpi DemiriDepartment of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Dimitris DionyssiouDepartment of Plastic Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Anne K GrothDepartment of Plastic Surgery, Hospital Erasto Gaertner, Curitiba, Brazil.
Norbert HeineDepartment of Plastic Surgery, Caritas Hospital St. Josef, Regensburg, Germany.
Joshua VorstenborschDivision of Plastic Surgery, McGill University, Montreal, Québec, Canada.
Kathryn V IsaacDivision of Plastic Surgery, The University of British Columbia, Vancouver, British Columbia, Canada.
Shan Shan QiuDepartment of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Patricia E EngelsDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.
Axelle SerreDepartment of Plastic, Reconstructive, and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.
Anna-Lena EberhardtDepartment of Radiation Oncology, University Hospital Basel, Basel, Switzerland.
Sonja EbnerDepartment of Obstetrics and Gynecology, Cantonal Hospital Basel-Landschaft, Liestal, Switzerland.
Matthias SchwenkglenksHealth Economics Facility, Department of Public Health, University of Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0001-7217-1173
Yvette StoelInstitute of Therapies and Rehabilitation, Division of Physiotherapy, Cantonal Hospital Winterthur, Winterthur, Switzerland.
Cornelia LeoBreast Center, Kantonsspital Baden AG, Baden, Switzerland.
Raymund E HorchDepartment of Plastic and Hand Surgery, Erlangen University Hospital, Erlangen, Germany.
Phillip BlondeelDepartment of Plastic and Reconstructive Surgery, University Hospital Ghent, Gent, Belgium.
Bjoern BehrDepartment of Plastic, Reconstructive and Aesthetic Surgery, KEM Kliniken Essen-Mitte, Essen, Germany.
Ulrich KneserDepartment of Hand, Plastic and Reconstructive Surgery, Burn Center, University Hospital Heidelberg, BG Klinik Ludwigshafen, Ludwigshafen, Germany.
Lukas PrantlDepartment of Plastic Surgery, University Hospital Regensburg, Regensburg, Germany.
Daniel T BollDepartment of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Cristina GranzieraNeurology Clinic and Policlinic, Departments of Head, Spine and Neuromedicine, Biomedicine and Clinical Research, University Hospital Basel, Basel, Switzerland.
Lars HemkensDepartment of Clinical Research, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0002-3444-1432
Nicole LindenblattDepartment of Plastic and Hand Surgery, University Hospital Zurich, Zurich, Switzerland.
Martin HaugDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Dirk J SchaeferDepartment of Plastic, Reconstructive, Aesthetic and Handsurgery, University Hospital Basel, Basel, Switzerland.
Christoph HircheDepartment of Plastic, Hand and Reconstructive Microsurgery, Hand Trauma and Replantation Centre, BG Unfallklinik Frankfurt am Main, Frankfurt am Main, Germany.
Andrea L PusicDivision of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Katrin SeidenstueckerDepartment of Plastic Surgery, Sana Kliniken Düsseldorf GmbH, Dusseldorf, Germany.
Yves HarderDepartment of Plastic and Hand Surgery, CHUV, Lausanne, Switzerland.
Walter WeberUniversity of Basel, Basel, Switzerland.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

introductionUp to one-fifth of breast cancer survivors will develop chronic breast cancer-related lymphoedema (BCRL). To date, complex physical decongestion therapy (CDT) is the gold standard of treatment. However, it is mainly symptomatic and often ineffective in preventing BCRL progression. Lymphovenous anastomosis (LVA) and vascularised lymph node transfer (VLNT) are microsurgical techniques that aim to restore lymphatic drainage. This international randomised trial aims to evaluate advantages of microsurgical interventions plus CDT versus CDT alone for BCRL treatment. METHODS AND ANALYSIS: The effectiveness of LVA and/or VLNT in combination with CDT, which may be combined with liposuction, versus CDT alone will be evaluated in routine practice across the globe. Patients with BCRL will be randomly allocated to either surgical or conservative therapy. The primary end point of this trial is the patient-reported quality of life (QoL) outcome 'lymphoedema-specific QoL', which will be assessed 15 months after randomisation. Secondary end points are further patient-reported outcomes (PROs), arm volume measurements, economic evaluations and imaging at different time points. A long-term follow-up will be conducted up to 10 years after randomisation. A total of 280 patients will be recruited in over 20 sites worldwide. ETHICS AND DISSEMINATION: This study will be conducted in compliance with the Declaration of Helsinki and the International Council for Harmonisation-Good Clinical Practice (ICH-GCP) E6 guideline. Ethical approval has been obtained by the lead ethics committee 'Ethikkommission Nordwest- und Zentralschweiz' (2023-00733, 22 May 2023). Ethical approval from local authorities will be sought for all participating sites. Regardless of outcomes, the findings will be published in a peer-reviewed medical journal. Metadata detailing the dataset's type, size and content will be made available, along with the full study protocol and case report forms, in public repositories in compliance with the Findability, Accessibility, Interoperability and Reuse principles. TRIAL REGISTRATION NUMBER: NCT05890677.

Indexed as

Breast Cancer LymphedemaBreast NeoplasmsConservative TreatmentLymphedemaMicrosurgeryAnastomosis, SurgicalEquivalence Trials as TopicFemaleHumansLipectomyLymph NodesMulticenter Studies as TopicPatient Reported Outcome MeasuresPragmatic Clinical Trials as TopicQuality of LifeRandomized Controlled Trials as Topicbreast tumoursclinical trialpatient reported outcome measuresplastic & reconstructive surgeryrandomized controlled trial

Identifiers

PMID39961719
PMCPMC11836839

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.