Revisiting lymphedema staging: Heterogeneous disease severity within a single limb

Disease staging systems serve several purposes, including standardizing communication among healthcare providers, guiding interventions, predicting prognosis, and monitoring treatment response. Currently, clinical staging systems for lymphedema classify the entire limb with a single stage, based on the assumption of uniform disease severity. 1 Douglass J. Kelly-Hope L. Comparison of staging systems to assess lymphedema caused by cancer therapies, lymphatic filariasis, and podoconiosis. Lymphat Res Biol. 2019; 17: 550https://doi.org/10.1089/LRB.2018.0063 Crossref PubMed Google Scholar , 2 Campisi C. Boccardo F. Lymphedema and microsurgery. Microsurgery. 2002; 22: 74-80https://doi.org/10.1002/micr.21728 Crossref PubMed Scopus (71) Google Scholar , 3 Lymphology Is The diagnosis and treatment of peripheral lymphedema: 2020 consensus document of the International Society of Lymphology. Lymphology. 2020; 53: 3-19 PubMed Google Scholar However, this classic assumption is often challenged by clinical observations.