title: Lower limb lymphedema and neurological complications after lymphadenectomy for gynecological cancer.
abstract: OBJECTIVE
  Lymphadenectomy is a frequent procedure for surgical staging of gynecological malignancies. Nevertheless, minor complications, such as lower limb lymphedema (LLL) and neurological complications (NCs), after pelvic and aorto-caval lymphadenectomy still remain underinvestigated. The present study considers short-term and long-term incidence and risk factors for LLL and NC in patients with gynecological cancer who underwent lymphadenectomy.
  
  
  METHODS
  In 2 different institutions, University of Turin and University of Lausanne, a total of 152 patients who received lymphadenectomy for endometrial, cervical, or ovarian cancer were retrospectively identified. During the follow-up, data about LLL and NC were collected by means of a questionnaire. Short-term and long-term incidence of LLL and NC was evaluated, and risk factors, such as age, body mass index, type of cancer, surgical approach, number and extension of the removed lymph nodes, presence of lymph node metastasis, and adjuvant treatments, were analyzed.
  
  
  RESULTS
  Short-term incidence of LLL and NC after lymphadenectomy was high (36%) and predictive of long-term persistence. Between the analyzed risk factors, number of removed lymph nodes and adjuvant radiotherapy were significantly associated with an increased incidence of minor complications (P < 0.05).
  
  
  CONCLUSIONS
  Lower limb lymphedema and NC are more frequent than expected. They are related to the radicality of lymphadenectomy and adjuvant radiotherapy. They affect the quality of life of the patients treated for gynecological cancer and their perceptions of healing. Minor complications are commonly persistent and need a prompt diagnosis and a specialized management to improve their prognosis.
authors.affiliation: *Department of Gynecological Oncology, Ospedale Mauriziano Umberto I, University of Turin, Turin, Italy; and †Département de Gynecologie-Obstétrique et Génétique Médical, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Biglia
authors.forename: Armando
authors.initials: A
authors.lastname: Librino
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Ottino
authors.forename: Enrico
authors.initials: E
authors.lastname: Panuccio
authors.forename: Alberto
authors.initials: A
authors.lastname: Daniele
authors.forename: Achtari
authors.initials: A
authors.lastname: Chahin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005833:Genital Neoplasms, Female / Q000628:therapy*; D006801:Humans; D015994:Incidence; D035002:Lower Extremity; D008160:Lumbosacral Plexus / Q000293:injuries*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000150:complications*; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012307:Risk Factors; D013997:Time Factors