Lymphangiosarcoma, a Rare Complication of Lymphostasis: An Observational Study on the Role of the Physiotherapist in Early Recognition and Medical Referral.

Abstract

Lymphangiosarcoma is a rare, malignant angiosarcoma that primarily develops in limbs with chronic lymphedema and presents with dermal lesions. Due to a 5-year survival rate of 22.4%, early detection and treatment are critical for improving prognosis. This study assessed physiotherapists' skills in recognizing suspicious dermal lesions in lymphedema patients with a focus on lymphangiosarcoma. An 11-question online survey was created using Google Forms that included academic training, practical experience, frequency of lymphatic treatments, ability to recognize suspicious dermal lesions, referral frequency to specialists, and opinions on specific training needs. The study was conducted from 9 February to 30 March, 2024 and it targeted Italian physiotherapists who manage patients with lymphedema. Responses were received from 170 physiotherapists. Only 12.9% had university education on dermal lesions in lymphedema patients, while 70.6% had postgraduate training. Additionally, 57.6% felt unable to recognize lymphangiosarcoma. Postgraduate education was correlated with the ability to recognize the pathology (p=0.047). Clinical experience and frequency of lymphatic treatments was associated with recognition and reporting of suspected cases (p<0.05). Findings suggest the need for increased awareness and specialized training among physiotherapists to improve early detection and treatment of lymphangiosarcoma in lymphedema patients. Enhanced postgraduate education and clinical experience may lead to better patient outcomes.