title: Evidence-based practice in the management of lower limb lymphedema after gynecological cancer.
abstract: OBJECTIVE
  Lower limb lymphedema (LLL) is characterized as a physical-functional chronic complication that impacts the quality of life of women who have gone through treatment for gynecological cancer. The present study aims to check the conservative treatments available for lymphedema after gynecological cancer in the context of evidence-based practice.
  
  
  METHODS
  The selection criteria included papers from May 1993 discussing treatment protocols used in LLL after treatment for gynecological cancer. The search was performed until October 2014 in MEDLINE, SciVerse, and PEDro using "rehabilitation," "treatment outcome," "therapeutics," "clinical protocol," "gynecologic surgery," "lower extremity," "lower limb," and "lymphedema" as keywords, focused on women with a previous diagnosis of gynecological cancer who received radiation and/or chemotherapy and/or surgery and/or lymphadenectomy as part of their treatment.
  
  
  RESULTS
  From 110 studies found, 3 articles that used the complex decongestive therapy (CDT) as a treatment protocol were selected. There were no randomized clinical trials associated with the conservative treatment of LLL post-treatment of gynecological cancer. The three selected articles are retrospective, and had the same outcome - decreased volume of the affected limb lymphedema.
  
  
  CONCLUSIONS
  Although LLL is more or as frequent and detrimental as upper limb lymphedema post-cancer treatment, there are only a few studies about this subject. Publications are even scarcer when considering studies with interventional approach. Randomized controlled trials are necessary to support rehabilitation resources on lymphedema post-gynecological cancer treatment.
authors.affiliation: a Department of Physiotherapy , Center of Health and Sport Sciences, Santa Catarina State University (UDESC) , Coqueiros , Florianópolis , Brazil.
authors.forename: Lisandra Fossari
authors.initials: LF
authors.lastname: Iwersen
authors.affiliation: a Department of Physiotherapy , Center of Health and Sport Sciences, Santa Catarina State University (UDESC) , Coqueiros , Florianópolis , Brazil.
authors.forename: Fabiana Flores
authors.initials: FF
authors.lastname: Sperandio
authors.affiliation: a Department of Physiotherapy , Center of Health and Sport Sciences, Santa Catarina State University (UDESC) , Coqueiros , Florianópolis , Brazil.
authors.forename: Ariana Machado
authors.initials: AM
authors.lastname: Toriy
authors.affiliation: a Department of Physiotherapy , Center of Health and Sport Sciences, Santa Catarina State University (UDESC) , Coqueiros , Florianópolis , Brazil.
authors.forename: Marina
authors.initials: M
authors.lastname: Palú
authors.affiliation: a Department of Physiotherapy , Center of Health and Sport Sciences, Santa Catarina State University (UDESC) , Coqueiros , Florianópolis , Brazil.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Medeiros da Luz
mesh_terms: D002908:Chronic Disease; D017281:Cost of Illness; D019317:Evidence-Based Medicine; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D035002:Lower Extremity; D008208:Lymphatic System / Q000503:physiopathology*; D008209:Lymphedema / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Hysterectomy; lymph node excision; physical therapy modalities; radiation oncology; rehabilitation; women’s health