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Lymphedema after treatment for endometrial cancer - A review of prevalence and risk factors
Highland Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
2017 (English)In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 211, 112-121 p.Article, review/survey (Refereed) Published
Abstract [en]

Lymphedema is one of the least studied complications of cancer treatment and a chronic condition with a substantial impact on health-related quality of life (HQoL). Lymphedema of the legs (LLL) constitutes a common adverse side effect of lymphadenectomy LA in gynecologic cancer treatment. Primary treatment of endometrial cancer (EC) comprises hysterectomy and bilateral salpingo-oophorectomy. Pelvic and para-aortic lymphadenectomy is recommended in prognostic high risk groups of EC. This review summarizes the published literature concerning the prevalence of LLL after treatment for EC, methods used for measuring LLL, risk factors and HQoL impact. The main findings are that the reported prevalence of LLL varies significantly between 0% and 50%. This is due to a lack of a generally accepted standardization of terminology in assessment of lymphedema. The studies use different methods to assess and grade lymphedema and often the methodology used for determining LLL is poorly described and lacks baseline measurement. Lymphadenectomy, number of lymph nodes removed, and radiation therapy seems to increase the risk for LLL. All studies dealing with HQoL show that women with LLL have impaired HQoL. The level of evidence in the published studies is generally low. Consequently it is difficult to make clear-cut conclusions about the true prevalence or determination of risk factors. More prospective longitudinal or randomized trials with LLL as the primary outcome are necessary before conclusions can be drawn regarding prevalence of LLL and risk factor determination in EC. An internationally accepted standardization for terminology and methodology in lymphedema in research is needed. (C) 2017 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE BV , 2017. Vol. 211, 112-121 p.
Keyword [en]
Endometrial cancer; Lower limb lymphedema; Prevalence; Risk factors; Quality of life
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:liu:diva-138285DOI: 10.1016/j.ejogrb.2017.02.021ISI: 000401218300020PubMedID: 28242470OAI: oai:DiVA.org:liu-138285DiVA: diva2:1109076
Note

Funding Agencies|Region Jonkoping County; Region Ostergotland County; Linkoping University; Swedish Cancer Society

Available from: 2017-06-13 Created: 2017-06-13 Last updated: 2017-06-13

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Wedin, MadeleneFredrikson, MatsKjölhede, Preben
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Division of Children's and Women's healthFaculty of Medicine and Health SciencesDivision of Neuro and Inflammation ScienceDepartment of Gynaecology and Obstetrics in Linköping
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European Journal of Obstetrics, Gynecology, and Reproductive Biology
Urology and Nephrology

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