Vanessa L Beesley1, Ingrid J Rowlands2, Sandi C Hayes3, Monika Janda3, Peter O'Rourke4, Louise Marquart4, Michael A Quinn5, Amanda B Spurdle6, Andreas Obermair7, Alison Brand8, Martin K Oehler9, Yee Leung10, Lesley McQuire11, Penelope M Webb2. 1. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. Electronic address: Vanessa.Beesley@qimrberghofer.edu.au. 2. Gynaecological Cancers Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 3. School of Public Health, Queensland University of Technology, Brisbane, QLD, Australia. 4. Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 5. Department of Obstetrics & Gynaecology, University of Melbourne, Melbourne, VIC, Australia. 6. Molecular Cancer Epidemiology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia. 7. Queensland Centre for Gynaecological Cancer, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia. 8. Department of Gynaecological Oncology, Westmead Hospital, Sydney, NSW, Australia. 9. Department of Gynaecological Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia. 10. School of Women's and Infants' Health, University of Western Australia, Perth, WA, Australia. 11. Consumer Representative, Sydney, NSW, Australia.
Abstract
OBJECTIVES: Few studies have assessed the risk and impact of lymphedema among women treated for endometrial cancer. We aimed to quantify cumulative incidence of, and risk factors for developing lymphedema following treatment for endometrial cancer and estimate absolute risk for individuals. Further, we report unmet needs for help with lymphedema-specific issues. METHODS: Women treated for endometrial cancer (n = 1243) were followed-up 3-5 years after diagnosis; a subset of 643 completed a follow-up survey that asked about lymphedema and lymphedema-related support needs. We identified a diagnosis of secondary lymphedema from medical records or self-report. Multivariable logistic regression was used to evaluate risk factors and estimates. RESULTS: Overall, 13% of women developed lymphedema. Risk varied markedly with the number of lymph nodes removed and, to a lesser extent, receipt of adjuvant radiation or chemotherapy treatment, and use of nonsteroidal anti-inflammatory drugs (pre-diagnosis). The absolute risk of developing lymphedema was >50% for women with 15+ nodes removed and 2-3 additional risk factors, 30-41% for those with 15+ nodes removed plus 0-1 risk factors or 6-14 nodes removed plus 3 risk factors, but ≤ 8% for women with no nodes removed or 1-5 nodes but no additional risk factors. Over half (55%) of those who developed lymphedema reported unmet need(s), particularly with lymphedema-related costs and pain. CONCLUSION: Lymphedema is common; experienced by one in eight women following endometrial cancer. Women who have undergone lymphadenectomy have very high risks of lymphedema and should be informed how to self-monitor for symptoms. Affected women need greater levels of support.
OBJECTIVES: Few studies have assessed the risk and impact of lymphedema among women treated for endometrial cancer. We aimed to quantify cumulative incidence of, and risk factors for developing lymphedema following treatment for endometrial cancer and estimate absolute risk for individuals. Further, we report unmet needs for help with lymphedema-specific issues. METHODS:Women treated for endometrial cancer (n = 1243) were followed-up 3-5 years after diagnosis; a subset of 643 completed a follow-up survey that asked about lymphedema and lymphedema-related support needs. We identified a diagnosis of secondary lymphedema from medical records or self-report. Multivariable logistic regression was used to evaluate risk factors and estimates. RESULTS: Overall, 13% of women developed lymphedema. Risk varied markedly with the number of lymph nodes removed and, to a lesser extent, receipt of adjuvant radiation or chemotherapy treatment, and use of nonsteroidal anti-inflammatory drugs (pre-diagnosis). The absolute risk of developing lymphedema was >50% for women with 15+ nodes removed and 2-3 additional risk factors, 30-41% for those with 15+ nodes removed plus 0-1 risk factors or 6-14 nodes removed plus 3 risk factors, but ≤ 8% for women with no nodes removed or 1-5 nodes but no additional risk factors. Over half (55%) of those who developed lymphedema reported unmet need(s), particularly with lymphedema-related costs and pain. CONCLUSION:Lymphedema is common; experienced by one in eight women following endometrial cancer. Women who have undergone lymphadenectomy have very high risks of lymphedema and should be informed how to self-monitor for symptoms. Affected women need greater levels of support.
Authors: Rudy S Suidan; Charlotte C Sun; Scott B Cantor; Andrea Mariani; Pamela T Soliman; Shannon N Westin; Karen H Lu; Sharon H Giordano; Larissa A Meyer Journal: Obstet Gynecol Date: 2018-07 Impact factor: 7.661
Authors: Ángela Río-González; Francisco Molina-Rueda; Domingo Palacios-Ceña; Isabel M Alguacil-Diego Journal: Support Care Cancer Date: 2018-01-12 Impact factor: 3.603