Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study.

Abstract

BACKGROUND:

Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment.

METHODS:

We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined.

RESULTS:

In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2 or higher and receiving radiation rarely responded to CPT.

CONCLUSIONS:

Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.

• Authors: Masato Yoshihara, Kaoru Kitamura, Satoko Tsuru, Ryoko Shimono, Hiromi Sakuda, Michinori Mayama, Sho Tano, Kaname Uno, Mayu Ohno Ukai, Yasuyuki Kishigami, Hidenori Oguchi, Akio Hirota
• Journal: BMC cancer (BMC Cancer) Vol. 22 Issue 1 Pg. 25 (Jan 03 2022) ISSN: 1471-2407 [Electronic] England
• PMID: 34980013 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021. The Author(s).

Topics

• Aged
• Body Mass Index
• Compression Bandages
• Female
• Genital Neoplasms, Female (physiopathology, surgery)
• Humans
• Linear Models
• Lower Extremity (physiopathology)
• Lymph Node Excision (adverse effects)
• Lymphedema (etiology, therapy)
• Middle Aged
• Physical Therapy Modalities
• Postoperative Complications (etiology, therapy)
• Prognosis
• Radiotherapy
• Retrospective Studies
• Risk Factors
• Treatment Outcome