title: Risk factors for lower-limb lymphedema after surgery for cervical cancer.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gynecology, Hokkaido University Graduate School of Medicine, N15W7 Kita-ku, Sapporo 060-8638, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohba
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Todo
authors.forename: Noriko
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Masanori
authors.initials: M
authors.lastname: Kaneuchi
authors.forename: Hidemichi
authors.initials: H
authors.lastname: Watari
authors.forename: Mahito
authors.initials: M
authors.lastname: Takeda
authors.forename: Satoko
authors.initials: S
authors.lastname: Sudo
authors.forename: Masataka
authors.initials: M
authors.lastname: Kudo
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kato
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery* / Q000628:therapy; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000601:surgery* / Q000628:therapy; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000628:therapy