Cormier JN, Askew RL, Mungovan KS, Xing Y, Ross MI, Armer JM, et al.
Cancer. Date of publication 2010 Nov 15;volume 116(22):5138-49.
1. Cancer. 2010 Nov 15;116(22):5138-49. doi: 10.1002/cncr.25458.
Lymphedema beyond breast cancer: a systematic review and meta-analysis of
cancer-related secondary lymphedema.
Cormier JN(1), Askew RL, Mungovan KS, Xing Y, Ross MI, Armer JM.
Author information:
(1)Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer
Center, Houston, TX, USA. jcormier@mdanderson.org
BACKGROUND: Secondary lymphedema is a debilitating, chronic, progressive
condition that commonly occurs after the treatment of breast cancer. The purpose
of the current study was to perform a systematic review and meta-analysis of the
oncology-related literature excluding breast cancer to derive estimates of
lymphedema incidence and to identify potential risk factors among various
malignancies.
METHODS: The authors systematically reviewed 3 major medical indices (MEDLINE,
Cochrane Library databases, and Scopus) to identify studies (1972-2008) that
included a prospective assessment of lymphedema after cancer treatment. Studies
were categorized according to malignancy, and data included treatment,
complications, lymphedema measurement criteria, lymphedema incidence, and
follow-up interval. A quality assessment of individual studies was performed
using established criteria for systematic reviews. Bayesian meta-analytic
techniques were applied to derive summary estimates when sufficient data were
available.
RESULTS: A total of 47 studies (7779 cancer survivors) met inclusion criteria:
melanoma (n = 15), gynecologic malignancies (n = 22), genitourinary cancers (n =
8), head/neck cancers (n = 1), and sarcomas (n = 1). The overall incidence of
lymphedema was 15.5% and varied by malignancy (P < .001): melanoma, 16% (upper
extremity, 5%; lower extremity, 28%); gynecologic, 20%; genitourinary, 10%;
head/neck, 4%; and sarcoma, 30%. Increased lymphedema risk was also noted for
patients undergoing pelvic dissections (22%) and radiation therapy (31%).
Objective measurement methods and longer follow-up were both associated with
increased lymphedema incidence.
CONCLUSIONS: Lymphedema is a common condition affecting cancer survivors with
various malignancies. The incidence of lymphedema is related to the type and
extent of treatment, anatomic location, heterogeneity of assessment methods, and
length of follow-up.
Copyright © 2010 American Cancer Society.
DOI: 10.1002/cncr.25458
PMID: 20665892 [Indexed for MEDLINE]
