GOG 244-The lymphedema and gynecologic cancer (LEG) study: Incidence and risk factors in newly diagnosed patients Journal Article
| Authors: | Carlson, J. W.; Kauderer, J.; Hutson, A.; Carter, J.; Armer, J.; Lockwood, S.; Nolte, S.; Stewart, B. R.; Wenzel, L.; Walker, J.; Fleury, A.; Bonebrake, A.; Soper, J.; Mathews, C.; Zivanovic, O.; Richards, W. E.; Tan, A.; Alberts, D. S.; Barakat, R. R. |
| Article Title: | GOG 244-The lymphedema and gynecologic cancer (LEG) study: Incidence and risk factors in newly diagnosed patients |
| Abstract: | Objectives: To evaluate the incidence and risk factors for lymphedema associated with surgery for gynecologic malignancies on GOG study 244. Methods: Women undergoing a lymph node dissection for endometrial, cervical, or vulvar cancer were eligible for enrollment. Leg volume was calculated from measurements at 10-cm intervals starting 10 cm above the bottom of the heel to the inguinal crease. Measurements were obtained preoperatively and postoperatively at 4–6 weeks, and at 3-, 6-, 9-, 12-, 18-, and 24- months. Lymphedema was defined as a limb volume change (LVC) ≥10% from baseline and categorized as mild: 10–19% LVC; moderate: 20–40% LVC; or severe: >40% LVC. Risk factors associated with lymphedema were also analyzed. Results: Of 1054 women enrolled on study, 140 were inevaluable due to inadequate measurements or eligibility criteria. This left 734 endometrial, 138 cervical, and 42 vulvar patients evaluable for LVC assessment. Median age was 61 years (range, 28–91) in the endometrial, 44 years (range, 25–83) in the cervical, and 58 years (range, 35–88) in the vulvar group. The incidence of LVC ≥10% was 34% (n = 247), 35% (n = 48), and 43% (n = 18), respectively. The peak incidence of lymphedema was at the 4–6 week assessment. Logistic regression analysis showed a decreased risk with advanced age (p = 0.0467). An exploratory analysis in the endometrial cohort showed an increased risk with a node count >8 (p = 0.033). Conclusions: For a gynecologic cancer, LVC decreased with age greater than 65, but increased with a lymph node count greater than 8 in the endometrial cohort. There was no association with radiation or other risk factors. © 2019 Elsevier Inc. |
| Keywords: | adult; aged; middle aged; cancer surgery; young adult; major clinical study; cancer risk; cancer adjuvant therapy; postoperative care; preoperative care; endometrial cancer; staging; lymph node dissection; endometrium cancer; prospective study; lymphadenectomy; disease association; clinical assessment; incidence; risk factor; risk assessment; lymphedema; uterine cervix cancer; clinical evaluation; postoperative infection; vulvar cancer; cervical cancer; vulva cancer; serum albumin; musculoskeletal system parameters; very elderly; human; female; priority journal; article; heel; limb volume change; dihydrotachysterol |
| Journal Title: | Gynecologic Oncology |
| Volume: | 156 |
| Issue: | 2 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2020-02-01 |
| Start Page: | 467 |
| End Page: | 474 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2019.10.009 |
| PUBMED: | 31837831 |
| PROVIDER: | scopus |
| PMCID: | PMC7018616 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 March 2020 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work