Lymphedema pp 507-513 | Cite as

Lower Extremity Cancers

  • Mi-Joung Lee
  • Stanley G. Rockson


Secondary lower limb lymphedema (LLL) is commonly associated with surgical excision of inguinofemoral lymph nodes and/or radiation of the respective node-bearing areas. The condition of LLL presents as progressive swelling of the leg(s), most typically within the first 12 months after the treatment for cancer. Once it develops, it is typically unremitting and often progressive.


Breast Cancer Survivor Compression Garment Groin Dissection Bioimpedance Spectroscopy Lower Limb Lymphedema 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Radhakrishnan K, Rockson SG. The clinical spectrum of lymphatic disease. Ann NY Acad Sci. 2008;1131:155-184.PubMedCrossRefGoogle Scholar
  2. 2.
    Beesley V, Janda M, Eakin E, Obermair A, Battistutta D. Lymphedema after gynecological cancer treatment: prevalence, correlates, and supportive care needs. Cancer. 2007;109:2607-2614.PubMedCrossRefGoogle Scholar
  3. 3.
    Ryan M, Stainton MC, Jaconelli C, Watts S, MacKenzie P, Mansberg T. The experience of lower limb lymphedema for women after treatment for gynecologic cancer. Oncol Nurs Forum. 2003;30:417-423. Online.PubMedCrossRefGoogle Scholar
  4. 4.
    Schirger A. Lymphedema. Cardiovasc Clin. 1983;13:293-305.PubMedGoogle Scholar
  5. 5.
    Lewis JM, Wald ER. Lymphedema praecox. J Pediatr. 1984;104:641-648.PubMedCrossRefGoogle Scholar
  6. 6.
    Harwood CA, Bull RH, Evans J, Mortimer PS. Lymphatic and venous function in lipoedema. Br J Dermatol. 1996;134:1-6.PubMedCrossRefGoogle Scholar
  7. 7.
    Wolfe JH, Kinmonth JB. The prognosis of primary lymphedema of the lower limbs. Arch Surg. 1981;116:1157-1160.PubMedGoogle Scholar
  8. 8.
    Mortimer PS. Swollen lower limb-2: lymphoedema. BMJ. 2000;320:1527-1529.PubMedCrossRefGoogle Scholar
  9. 9.
    Langbecker D, Hayes SC, Newman B, Janda M. Treatment for upper-limb and lower-limb lymphedema by professionals specializing in lymphedema care. Eur J Cancer Care (Engl). 2008;17:557-564.Google Scholar
  10. 10.
    Yost KJ, Yount SE, Eton DT, et al. Validation of the Functional Assessment of Cancer Therapy-Breast Symptom Index (FBSI). Breast Cancer Res Treat. 2005;90:295-298.PubMedCrossRefGoogle Scholar
  11. 11.
    Tiwari A, Myint F, Hamilton G. Management of lower limb lymphoedema in the United Kingdom. Eur J Vasc Endovasc Surg. 2006;31:311-315.PubMedCrossRefGoogle Scholar
  12. 12.
    Burnand K, Clemson G, Morland M, Jarrett PEM, Browese NL. Venous lipodermatosclerosis: treatment by fibrinolytic enhancement and elastic compression. Br Med J. 1980;280:7-11.PubMedCrossRefGoogle Scholar
  13. 13.
    Caseley-Smith J. Measuring and representing peripheral oedema and its alterations. Lymphology. 1994;27:56-70.Google Scholar
  14. 14.
    Liu NF, Olszewski W. Use of tonometry to assess lower extremity lymphedema. Lymphology. 1992;25:155-158.PubMedGoogle Scholar
  15. 15.
    Ward LC. Regarding Edema and leg volume: methods of assessment. Angiology. 2000;50:615-616.CrossRefGoogle Scholar
  16. 16.
    Moseley AL, Carati CJ, Piller NB. A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol. 2007;18:639-646.PubMedCrossRefGoogle Scholar
  17. 17.
    Hinrichs CS, Gibbs JF, Driscoll D, et al. The effectiveness of complete decongestive physiotherapy for the treatment of lymphedema following groin dissection for melanoma. J Surg Oncol. 2004;85:187-192.PubMedCrossRefGoogle Scholar
  18. 18.
    Gary DE. Lymphedema diagnosis and management. J Am Acad Nurse Pract. 2007;19:72-78.PubMedCrossRefGoogle Scholar
  19. 19.
    Tada H, Teramukai S, Fukushima M, Sasaki H. Risk factors for lower limb lymphedema after lymph node dissection in patients with ovarian and uterine carcinoma. BMC Cancer. 2009;9:47-52.PubMedCrossRefGoogle Scholar
  20. 20.
    Ryan M, Stainton MC, Slaytor EK, Jaconelli C, Watts S, Mackenzie P. Aetiology and prevalence of lower limb lymphoedema following treatment for gynaecological cancer. Aust N Z J Obstet Gynaecol. 2003;43:148-151.PubMedCrossRefGoogle Scholar
  21. 21.
    Hong JH, Tsai CS, Lai CH, et al. Postoperative low-pelvic irradiation for stage I-IIA cervical cancer patients with risk factors other than pelvic lymph node metastasis. Int J Radiat Oncol Biol Phys. 2002;53:1284-1290.PubMedCrossRefGoogle Scholar
  22. 22.
    Fuller J, Guderian D, Kohler C, Schneider A, Wendt TG. Lymph edema of the lower extremities after lymphadectomy and radiotherapy for cervical cancer. Strahlenther Onkol. 2008;184:206-211.PubMedCrossRefGoogle Scholar
  23. 23.
    Halaska MJ, Novackova M, Mala I, et al. A prospective study of postoperative lymphedema after surgery for cervical cancer. Int J Gynecol Cancer. 2010;20:900-904.PubMedCrossRefGoogle Scholar
  24. 24.
    Todo Y, Yamamoto R, Minobe S, et al. Risk factors for postoperative lower-extremity lymphedema in endometrial cancer survivors who had treatment including lymphadenectomy. Gynecol Oncol. 2010;119(1):60-64.PubMedCrossRefGoogle Scholar
  25. 25.
    Abu-Rustum NR, Alektiar K, Iasonos A, et al. The incidence of symptomatic lower-extremity lymphedema following treatment of uterine corpus malignancies: a 12-year experience at Memorial Sloan-Kettering Cancer Center. Gynecol Oncol. 2006;103:714-718.PubMedCrossRefGoogle Scholar
  26. 26.
    Judson P, Jonson AL, Paley PJ, et al. A prospective, randomized study analyzing sartorius transposition following inguinal-femoral lymphadenectomy. Gynecol Oncol. 2004;95:226-230.PubMedCrossRefGoogle Scholar
  27. 27.
    Gaarenstroom KN, Kenter GG, Trimbos JB, et al. Postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using separate groin incisions. Int J Gynecol Cancer. 2003;13:522-527.PubMedCrossRefGoogle Scholar
  28. 28.
    Amdur RJ, Parsons JT, Fitzgerald LT, Million RR. Adenocarcinoma of the prostate treated with external-beam radiation therapy: 5-year minimum follow-up. Radiother Oncol. 1990;18:235-246.PubMedCrossRefGoogle Scholar
  29. 29.
    Greskovich FJ, Sagars GK, Sherman NE, Johnson DE. Complications following external beam radiation therapy for prostate cancer: an analysis of patients treated with and without staging pelvic lymphadenectomy. J Urol. 1991;146:798-802.PubMedGoogle Scholar
  30. 30.
    Kavoussi LR, Sosa E, Chandhoke P, et al. Complications of laparoscopic pelvic lymph node dissection. J Urol. 1993;149:322-325.PubMedGoogle Scholar
  31. 31.
    Bevan-Thomas R, Slaton JW, Pettaway CA. Contemporary morbidity from lymphadenectomy for penile squamous cell carcinoma: the M.D. Anderson Cancer Center Experience. J Urol. 2002;167:1638-1642.PubMedCrossRefGoogle Scholar
  32. 32.
    Jacobellis U. Modified radical inguinal lymphadenectomy for carcinoma of the penis: technique and results. J Urol. 2003;169:1349-1352.PubMedCrossRefGoogle Scholar
  33. 33.
    Ravi R. Morbidity following groin dissection for penile carcinoma. Br J Urol. 1993;72:941-945.PubMedCrossRefGoogle Scholar
  34. 34.
    de Vries M, Vonkeman WG, van Ginkel RJ, Hoekstra HJ. Morbidity after inguinal sentinel lymph node biopsy and completion lymph node dissection in patients with cutaneous melanoma. Eur J Surg Oncol. 2006;32:785-789.PubMedCrossRefGoogle Scholar
  35. 35.
    Ballo MT, Zagars GK, Gershenwald JE, et al. A critical assessment of adjuvant radiotherapy for inguinal lymph node metastases from melanoma. Ann Surg Oncol. 2004;11:1079-1084.PubMedCrossRefGoogle Scholar
  36. 36.
    Serpell JW, Carne PW, Bailey M. Radical lymph node dissection for melanoma. ANZ J Surg. 2003;73:294-299.PubMedCrossRefGoogle Scholar
  37. 37.
    Burmeister BH, Smithers BM, Davis S, et al. Radiation therapy following nodal surgery for melanoma: an analysis of late toxicity. ANZ J Surg. 2002;72:344-348.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2011

Authors and Affiliations

  • Mi-Joung Lee
    • 1
  • Stanley G. Rockson
  1. 1.Division of Cardiovascular MedicineStanford University School of Medicine, Falk Cardiovascular Research CenterStanfordUSA

Personalised recommendations