title: Incidence and risk factors of lower-extremity lymphedema after radical surgery with or without adjuvant radiotherapy in patients with FIGO stage I to stage IIA cervical cancer.
abstract: OBJECTIVE
  This study aimed to determine the incidence and risk factors of lower-extremity lymphedema (LEL) in women who had radical surgery with or without adjuvant radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) stage I to stage IIA cervical cancer.
  
  
  METHODS
  The medical records were reviewed retrospectively on patients with histologically confirmed FIGO stage I to IIA cervical cancer. Lower-extremity lymphedema-related medical problems such as peripheral vascular disease, congestive heart failure, or chronic renal disease were excluded. A logistic regression analysis was used to examine the relationship between variable clinical characteristics and development of LEL.
  
  
  RESULTS
  We evaluated 707 patients. Of the 707 patients evaluated, we excluded 92 patients who had received radiotherapy as the initial therapy and 19 patients with LEL related to medical problems. Seventy-five patients (12.6%) developed LEL. The incidence was high in patients with adjuvant radiotherapy (odds ratio, 3.47; 95% confidence interval, 2.086-5.788; P = 0.000), with 78.7% of the patients with LEL having developed the condition within 3 years after initial treatment.
  
  
  CONCLUSIONS
  Adjuvant radiotherapy was significantly associated with development of LEL in women who had undergone radical surgery with lymphadenectomy for FIGO stage I to stage IIA cervical cancer. The possibility for the occurrence of LEL must be fully explained before treatment and patients should be provided with the appropriate preventive education. Further prospective studies are needed to confirm the incidence and risk factors for LEL.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Catholic University, Seoul, Korea.
authors.forename: Jin Hwi
authors.initials: JH
authors.lastname: Kim
authors.forename: Ji Hyang
authors.initials: JH
authors.lastname: Choi
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Ki
authors.forename: Sung Jong
authors.initials: SJ
authors.lastname: Lee
authors.forename: Joo Hee
authors.initials: JH
authors.lastname: Yoon
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Lee
authors.forename: Tae Chul
authors.initials: TC
authors.lastname: Park
authors.forename: Jong Sup
authors.initials: JS
authors.lastname: Park
authors.forename: Seog Nyeon
authors.initials: SN
authors.lastname: Bae
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Hur
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D015994:Incidence; D035002:Lower Extremity / Q000473:pathology* / Q000528:radiation effects / Q000601:surgery; D008197:Lymph Node Excision / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D008209:Lymphedema / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000628:therapy