Lower extremity edema in patients with early ovarian cancer

Abstract

BackgroundThe objective of this study was to investigate clinical manifestations of lower extremity edema (LEE) in early ovarian cancer.MethodsPatients with early ovarian cancer who underwent staging surgery between January 2001 and December 2010. Medical records for LEE and/or responses to the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) were evaluated.ResultsPatients had a median age of 46 years. Twenty-nine patients (40.8%) had past (13 patients, 44.8%) and/or current patient-reported LEE (16 patients, 55.2%). Symptoms reported on the GCLQ in over 20% of respondents were numbness, firmness/tightness, swelling, heaviness, limited movement of knee, and aching. GCLQ total symptoms score was significantly higher in patients with current LEE. Most of the LEE (25/29, 86.2%) developed within 12 months after surgery and LEE lasted more than 6 months in approximately two-thirds of the patients (18/29, 62.1%). Only half of the patients (52.1%) indicated knowledge of lymphedema: 86.2% of LEE patients and 28.6% of patients with no LEE.ConclusionsAlthough a significant proportion of patients with ovarian cancer have LEE after surgery, most are not aware of lymphedema until they develop. Education and analyses for LEE and lymphedema are needed in patients with ovarian cancer.

Impact of lower limb lymphedema on quality of life in gynecologic cancer survivors after pelvic lymph node dissection

“…Recently, Beesley et al reported that 13% of patients treated with endometrial cancer experienced LLL [6]. Our previous study also showed that even in early-stage ovarian cancer cases, about four of every 10 patients reported past and/or current lower extremity edema and related symptoms after surgical staging including pelvic LND [7].…”

Lower extremity lymphedema in patients with gynecologic malignancies

“…Again, lymphadenectomy is the most important prognostic factor 38 39. In ovarian cancer, surgical evaluation of the pelvic nodes and para-aortics up to the renal vessels is considered the standard of care for early-stage disease confined to the ovary and/or pelvis 40. Lim et al examined a cohort of ovarian cancer patients with early-stage disease, 97.2% of whom underwent lymphadenectomy, and reported that 55% had lymphedema.…”

“…Lim et al examined a cohort of ovarian cancer patients with early-stage disease, 97.2% of whom underwent lymphadenectomy, and reported that 55% had lymphedema. It should be noted that 57.4% had greater than 35 lymph nodes excised 40. The majority of patients with newly diagnosed ovarian cancer actually present with advanced stage disease, in which case such a systematic lymphadenectomy is not routinely performed except in the setting of grossly enlarged nodes 41…”

Lower Body Lymphedema in Patients with Gynecologic Cancer

“…The reported incidence of LLL among OC patients ranges from 4.7% to 40.8% (13,56) and most of the studies were performed on heterogeneous cohorts including also patients with CC and EC (1,13,14,34,39,40). Only one study specifically addressed OC patients by means of subjective evaluation (56), reporting an incidence of 40.8% (past 18.3% and current 22.5%); LLL developed in most of the cases (86.2%) in the first year after surgery and persisted more than 6 months after treatment in 62.1% of the women.…”