Hu H, Fu M, Huang X, Huang J, Gao J, et al.
Translational cancer research. Date of publication 2022 Jun 1;volume 11(6):1713-1721.
1. Transl Cancer Res. 2022 Jun;11(6):1713-1721. doi: 10.21037/tcr-22-1256.
Risk factors for lower extremity lymphedema after cervical cancer treatment: a
systematic review and meta-analysis.
Hu H(#)(1), Fu M(#)(2), Huang X(3), Huang J(1), Gao J(3).
Author information:
(1)Department of Obstetrics, People's Hospital of Wanning Hainan, Wanning, China.
(2)Department of Gynecology, Danzhou People's Hospital, Danzhou, China.
(3)Department of Traditional Chinese Medicine, the First Affiliated Hospital of
Hainan Medical University, Haikou, China.
(#)Contributed equally
Background: The main risk factors for the development of lower extremity
lymphedema after cervical cancer treatment are controversial. Our aim was to
evaluate the main risk factors of lower extremity lymphedema after cervical
cancer treatment.
Methods: We searched the English database PubMed, Embase, Medline, Central and
the Chinese database CNKI to obtain relevant studies. Inclusion criteria: (I) the
subjects were cervical cancer patients receiving treatment; (II) cohort studies
or case-control studies; (III) exposure factors were not limited; (IV) the
outcome was lower extremity lymphedema after treatment; (V) the odds ratio (OR)
value and 95% confidence interval of exposure factors can be obtained. The
chi-square test was used to test for heterogeneity. The Egger test was used to
test for publication bias. OR (95% CI) was calculated using inverse variance.
Results: A total of 12 retrospective studies with a total of 3,401 patients were
included in this literature review. The incidence of lower extremity lymphedema
after cervical cancer treatment was between 12.6% and 43.1%. Meta-analysis
results demonstrated that the main risk factors were: body mass index (BMI) (OR
=1.37, 95% CI: 1.10-1.71, P=0.005), age (OR =1.68, 95% CI: 1.07-2.64, P=0.02),
International Federation of Gynecology and Obstetrics (FIGO) stage (OR =1.50, 95%
CI: 1.24-1.82, P<0.001), radiotherapy (OR =2.87, 95% CI: 1.71-4.82, P<0.001),
lymph node (LN) dissection (OR =3.24, 95% CI: 1.44-7.31, P=0.005), and the number
of LNs dissected (OR =2.34, 95% CI: 1.80-3.05, P<0.001). Egger's test showed that
there was no publication bias among the literatures (P>0.05).
Conclusions: BMI, age, FIGO stage, radiotherapy, LN dissection and the number of
LNs removed are the main risk factors for lower extremity lymphedema after
cervical cancer treatment. When treating patients with cervical cancer, effective
interventions should be sought to reduce the risk of lower extremity edema.
2022 Translational Cancer Research. All rights reserved.
DOI: 10.21037/tcr-22-1256
PMCID: PMC9273676
PMID: 35836533
Conflict of interest statement: Conflicts of Interest: All authors have completed
the ICMJE uniform disclosure form (available at
https://tcr.amegroups.com/article/view/10.21037/tcr-22-1256/coif). The authors
have no conflicts of interest to declare.
