Journal
GYNECOLOGIC ONCOLOGY
Volume 136, Issue 1, Pages 87-93Publisher
ACADEMIC PRESS INC ELSEVIER SCIENCE
DOI: 10.1016/j.ygyno.2014.11.006
Keywords
Lower limb lymphedema; Endometrial cancer; Risk factors; Unmet needs
Categories
Funding
- National Health and Medical Research Council (NHMRC) of Australia [339435]
- Cancer Council Tasmania [403031, 457636]
- Cancer Australia Priority Driven Collaborative Cancer Research Scheme [552468]
- NHMRC program [552429]
- NHMRC
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Objectives. Few studies have assessed the risk and impact of lymphedema among women treated for endometrial cancer. We aimed to quantify cumulative incidence of, and risk factors for developing lymphedema following treatment for endometrial cancer and estimate absolute risk for individuals. Further, we report unmet needs for help with lymphedema-specific issues. Methods. Women treated for endometrial cancer (n = 1243) were followed-up 3-5 years after diagnosis; a subset of 643 completed a follow-up survey that asked about lymphedema and lymphedema-related support needs. We identified a diagnosis of secondary lymphedema from medical records or self-report. Multivariable logistic regression was used to evaluate risk factors and estimates. Results. Overall, 13% of women developed lymphedema. Risk varied, markedly with the number of lymph nodes removed and, to a lesser extent, receipt of adjuvant radiation or chemotherapy treatment, and use of nonsteroidal anth-inflammatory drugs (pre-diagnosis). The absolute risk of developing lymphedema was >50% for women with 15 + nodes removed and 2-3 additional risk factors, 30-41% for those with 15 + nodes removed plus 0-1 risk factors or 6-14 nodes removed plus 3 risk factors, but <= 8% for women with no nodes removed or 1-5 nodes but no additional risk factors. Over half (55%) of those who developed lymphedema reported unmet need(s), particularly with lymphedema-related costs and pain. Conclusion. Lymphedema is common; experienced by one in eight women following endometrial cancer. Women who have undergone lymphadenectomy have very high risks of lymphedema and should be informed how to self-monitor for symptoms. Affected women need greater levels of support. (C) 2014 Elsevier Inc. All rights reserved.
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