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

International Journal of Clinical Oncology volume 16, pages 238–243 (2011)Cite this article

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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Acknowledgments

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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Authors and Affiliations

  1. Department of Gynecology, Hokkaido University Graduate School of Medicine, N15W7 Kita-ku, Sapporo, 060-8638, Japan

    Yoko Ohba, Noriko Kobayashi, Masanori Kaneuchi, Hidemichi Watari, Mahito Takeda, Satoko Sudo, Masataka Kudo & Noriaki Sakuragi

  2. Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 3-54, Kikusui 4-jo 2-chome, Shiroishi-ku, Sapporo, 003-0804, Japan

    Yoko Ohba, Yukiharu Todo & Hidenori Kato

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  1. Yoko Ohba
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  2. Yukiharu Todo
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Correspondence to Noriaki Sakuragi.

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Ohba, Y., Todo, Y., Kobayashi, N. et al. Risk factors for lower-limb lymphedema after surgery for cervical cancer. Int J Clin Oncol 16, 238–243 (2011). https://doi.org/10.1007/s10147-010-0171-5

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  • DOI: https://doi.org/10.1007/s10147-010-0171-5

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