International Journal of Clinical Oncology

, Volume 16, Issue 3, pp 238–243 | Cite as

Risk factors for lower-limb lymphedema after surgery for cervical cancer

  • Yoko Ohba
  • Yukiharu Todo
  • Noriko Kobayashi
  • Masanori Kaneuchi
  • Hidemichi Watari
  • Mahito Takeda
  • Satoko Sudo
  • Masataka Kudo
  • Hidenori Kato
  • Noriaki Sakuragi
Original Article



Lower-limb lymphedema (LLL) is a prevalent complication that is encountered after treatment for gynecological malignancies. The aim of this study was to evaluate the risk factors for postoperative LLL in patients with cervical cancer.


We conducted a retrospective chart review for patients who had undergone surgery, including systematic lymphadenectomy, for cervical cancer. Patients who died of cancer, were evaluated for short periods of time (<2 years), had missing medical records, or were suffering from deep venous thrombosis were excluded. We utilized the International Society of Lymphology staging of lymphedema severity as the diagnostic criteria for LLL, and patients with stage II or III lymphedema, as objectively determined by physicians, were included in the group of patients with LLL. Multivariate analysis was performed to confirm independent risk factors.


A total of 155 patients with cervical cancer were evaluated. Thirty-one patients (20.0%) contracted LLL with a median follow-up of 6.1 years. Suprafemoral node dissection (odds ratio, 9.5; 95% confidence interval, 1.2–73.3; P = 0.031) and adjuvant radiotherapy (3.7; 1.2–10.9; P = 0.019) were identified as independent risk factors.


Given that the effectiveness of the above two therapeutic options for cervical cancer is currently controversial, the clinical benefits of these therapies should be reevaluated specifically to conserve the quality of life for patients with this disease.


Cervical cancer Lower-limb lymphedema Surgery Risk factor 



The authors thank Yusuke Ohba (Hokkaido University) for drafting the manuscript and Drs. M. Nakatani, Y. Suzuki, S. Minobe, and K. Okamoto (Hokkaido Cancer Center) for helpful discussion. This work was supported in part by grants from the Japan Society for the Promotion of Science (KAKENHI: 22591843, 22591844).

Conflict of interest

No author has any conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2011

Authors and Affiliations

  • Yoko Ohba
    • 1
    • 2
  • Yukiharu Todo
    • 2
  • Noriko Kobayashi
    • 1
  • Masanori Kaneuchi
    • 1
  • Hidemichi Watari
    • 1
  • Mahito Takeda
    • 1
  • Satoko Sudo
    • 1
  • Masataka Kudo
    • 1
  • Hidenori Kato
    • 2
  • Noriaki Sakuragi
    • 1
  1. 1.Department of GynecologyHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Division of Gynecologic Oncology, National Hospital OrganizationHokkaido Cancer CenterSapporoJapan

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