title: Postoperative Lower Extremity Edema in Patients with Primary Endometrial Cancer.
abstract: OBJECTIVE
  The goal of this study was to investigate clinical manifestations of lower extremity edema (LEE) after lymph node dissection in patients with primary endometrial cancer.
  
  
  METHODS
  Women with primary endometrial cancer who underwent staging surgery between November 2001 and March 2011 were included in the study. Medical records and/or responses to the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) were used for LEE evaluation.
  
  
  RESULTS
  All 154 patients underwent pelvic lymph node dissection, and 126 patients (81.8 %) underwent paraaortic LN dissection. The median age of the patients was 52 years, the majority had stage I cancer (78.6 %), and most had endometrioid histology (90.9 %). The most frequent GCLQ responses were "experienced swelling" (35.7 %), "experienced numbness" (30.5 %), "experienced heaviness" (29.9 %), and "experienced aching" (29.9 %). Sixty-four patients (41.6 %) had previous (9/64, 14.1 %) and/or current (55/64, 85.9 %) patient-reported LEE. Most patients developed LEE within 12 months after surgery (39/56, 69.6 %), and LEE lasted for more than 12 months in most patients (45/56, 80.4 %). Three patients reported recurrent LEE after recovery. Multivariate logistic regression identified the number of dissected pelvic lymph node (≥21) as a risk factor for LEE [odds ratio (OR) 3.28; 95 % confidence interval (CI) 1.058-10.136] and postoperative radiotherapy (OR 3.81, 95 % CI 1.67-8.69).
  
  
  CONCLUSIONS
  LEE developed in more than one-third of patients with endometrial cancer after surgery, and LEE lasted for more than 12 months in most patients. A high number of dissected pelvic lymph nodes and postoperative radiotherapy is associated with LEE.
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.|Department of Gynecologic Oncology and Minimally Invasive Surgery, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: Hyo Sook
authors.initials: HS
authors.lastname: Bae
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea. gynlim@gmail.com.|Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea. gynlim@gmail.com.
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Jeong Seon
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.|Department of Nursing, Sorabol College, Gyeongju-Si, Gyeongsangbuk-do, Korea.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Biostatistics Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Seo
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.|Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Sokbom
authors.initials: S
authors.lastname: Kang
authors.affiliation: Rehabilitation Medicine, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Chung
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.|Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Joo-Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.|Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea.
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Park
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D035002:Lower Extremity / Q000473:pathology*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008209:Lymphedema / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors