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Incidence and risk factors for lower limb lymphedema associated with endometrial cancer: Results from a prospective, longitudinal cohort study.
Gynecol Oncol. 2020 Jun 01 [Online ahead of print]GO

Abstract

BACKGROUND

Evidence on the incidence and risk factors for lower limb lymphedema (LLL) associated with endometrial cancer is limited. Our objective was to use data from a prospective, longitudinal gynecological cancer cohort study to determine LLL incidence up to 24 months post-diagnosis of endometrial cancer and to explore the relationship between personal and treatment-related factors and risk of developing LLL.

METHODS

Women recently diagnosed with endometrial cancer (n = 235) were evaluated at regular intervals post-diagnosis (up to 3-monthly) using bioimpedance spectroscopy (BIS) and self-reported leg swelling (SRLS).

RESULTS

Incidence of LLL at 24 months post-diagnosis was 33% and 45% according to BIS and SRLS, respectively. When analyses were restricted to obese women, incidence at 24 months post-diagnosis increased to 67% (BIS) and 54% (SRLS). Following adjusted analyses, higher body mass index was associated with higher odds of baseline lymphedema (BIS: OR 1.91, 95% CI 1.47-2.49, p < .01; SRLS: OR 1.06, 95% CI 1.00-1.12, p < .01) and LLL incidence by 24 months post-diagnosis (BIS: OR 1.29, 95% CI: 0.99-1.68, p = .055; SRLS: OR 1.06, 95% CI 1.02-1.11, p = .008). According to SRLS, presence of comorbidities was also associated with baseline lymphedema (OR: 1.43, 95% CI: 1.15-1.78, p = .001), and more extensive lymph node dissection (OR 1.06, 95% CI: 1.01-1.12, p = .026) and receipt of chemotherapy (OR: 2.65, 95% CI: 1.12-6.29, p = .027) were identified as risk factors for lymphedema incidence.

CONCLUSIONS

These findings suggest that LLL following endometrial cancer is common, particularly in women with high body mass index, or comorbidities, and those requiring more extensive lymph node dissection or chemotherapy. Future studies should examine the potential of weight loss intervention as a strategy to reduce LLL incidence.

Authors+Show Affiliations

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia; Princess Alexandra Hospital, Occupational Therapy Department, Brisbane, Queensland, Australia. Electronic address: amanda.pigott@health.qld.gov.au.School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Royal Brisbane and Women's Hospital, Queensland Centre of Gynaecological Research, Brisbane, Queensland, Australia.Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland, Australia.Royal Brisbane and Women's Hospital, Physiotherapy Department, Brisbane, Queensland, Australia.Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32499070

Citation

Pigott, Amanda, et al. "Incidence and Risk Factors for Lower Limb Lymphedema Associated With Endometrial Cancer: Results From a Prospective, Longitudinal Cohort Study." Gynecologic Oncology, 2020.
Pigott A, Obermair A, Janda M, et al. Incidence and risk factors for lower limb lymphedema associated with endometrial cancer: Results from a prospective, longitudinal cohort study. Gynecol Oncol. 2020.
Pigott, A., Obermair, A., Janda, M., Vagenas, D., Ward, L. C., Reul-Hirche, H., & Hayes, S. C. (2020). Incidence and risk factors for lower limb lymphedema associated with endometrial cancer: Results from a prospective, longitudinal cohort study. Gynecologic Oncology. https://doi.org/10.1016/j.ygyno.2020.04.702
Pigott A, et al. Incidence and Risk Factors for Lower Limb Lymphedema Associated With Endometrial Cancer: Results From a Prospective, Longitudinal Cohort Study. Gynecol Oncol. 2020 Jun 1; PubMed PMID: 32499070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Incidence and risk factors for lower limb lymphedema associated with endometrial cancer: Results from a prospective, longitudinal cohort study. AU - Pigott,Amanda, AU - Obermair,Andreas, AU - Janda,Monika, AU - Vagenas,Dimitrios, AU - Ward,Leigh C, AU - Reul-Hirche,Hildegard, AU - Hayes,Sandra C, Y1 - 2020/06/01/ PY - 2020/01/20/received PY - 2020/04/23/accepted PY - 2020/6/6/entrez JF - Gynecologic oncology JO - Gynecol. Oncol. N2 - BACKGROUND: Evidence on the incidence and risk factors for lower limb lymphedema (LLL) associated with endometrial cancer is limited. Our objective was to use data from a prospective, longitudinal gynecological cancer cohort study to determine LLL incidence up to 24 months post-diagnosis of endometrial cancer and to explore the relationship between personal and treatment-related factors and risk of developing LLL. METHODS: Women recently diagnosed with endometrial cancer (n = 235) were evaluated at regular intervals post-diagnosis (up to 3-monthly) using bioimpedance spectroscopy (BIS) and self-reported leg swelling (SRLS). RESULTS: Incidence of LLL at 24 months post-diagnosis was 33% and 45% according to BIS and SRLS, respectively. When analyses were restricted to obese women, incidence at 24 months post-diagnosis increased to 67% (BIS) and 54% (SRLS). Following adjusted analyses, higher body mass index was associated with higher odds of baseline lymphedema (BIS: OR 1.91, 95% CI 1.47-2.49, p < .01; SRLS: OR 1.06, 95% CI 1.00-1.12, p < .01) and LLL incidence by 24 months post-diagnosis (BIS: OR 1.29, 95% CI: 0.99-1.68, p = .055; SRLS: OR 1.06, 95% CI 1.02-1.11, p = .008). According to SRLS, presence of comorbidities was also associated with baseline lymphedema (OR: 1.43, 95% CI: 1.15-1.78, p = .001), and more extensive lymph node dissection (OR 1.06, 95% CI: 1.01-1.12, p = .026) and receipt of chemotherapy (OR: 2.65, 95% CI: 1.12-6.29, p = .027) were identified as risk factors for lymphedema incidence. CONCLUSIONS: These findings suggest that LLL following endometrial cancer is common, particularly in women with high body mass index, or comorbidities, and those requiring more extensive lymph node dissection or chemotherapy. Future studies should examine the potential of weight loss intervention as a strategy to reduce LLL incidence. SN - 1095-6859 UR - https://www.unboundmedicine.com/medline/citation/32499070/Incidence_and_risk_factors_for_lower_limb_lymphedema_associated_with_endometrial_cancer:_Results_from_a_prospective,_longitudinal_cohort_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-8258(20)31012-X DB - PRIME DP - Unbound Medicine ER -
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