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Incidence and Risk Factors of Lower-Extremity Lymphedema After Radical Surgery With or Without Adjuvant Radiotherapy in Patients With FIGO Stage I to Stage IIA Cervical Cancer
  1. Jin Hwi Kim, MD*,
  2. Ji Hyang Choi, MD,
  3. Eun Young Ki, MD*,
  4. Sung Jong Lee, MD, PhD*,
  5. Joo Hee Yoon, MD, PhD*,
  6. Keun Ho Lee, MD, PhD*,
  7. Tae Chul Park, MD, PhD*,
  8. Jong Sup Park, MD, PhD*,
  9. Seog Nyeon Bae, MD, PhD* and
  10. Soo Young Hur, MD, PhD*
  1. *Department of Obstetrics and Gynecology, School of Medicine, Catholic University; and
  2. Department of Obstetrics and Gynecology, Seoul Medical Center, Seoul, Korea.
  1. Address correspondence and reprint requests to Soo Young Hur, MD, PhD, Department of Obstetrics and Gynecology, School of Medicine, Catholic University, 505 Banpo-dong, Seocho-gu, Seoul, Korea (Postcode 137-040). E-mail:


Objective This study aimed to determine the incidence and risk factors of lower-extremity lymphedema (LEL) in women who had radical surgery with or without adjuvant radiotherapy for International Federation of Gynecology and Obstetrics (FIGO) stage I to stage IIA cervical cancer.

Methods The medical records were reviewed retrospectively on patients with histologically confirmed FIGO stage I to IIA cervical cancer. Lower-extremity lymphedema–related medical problems such as peripheral vascular disease, congestive heart failure, or chronic renal disease were excluded. A logistic regression analysis was used to examine the relationship between variable clinical characteristics and development of LEL.

Results We evaluated 707 patients. Of the 707 patients evaluated, we excluded 92 patients who had received radiotherapy as the initial therapy and 19 patients with LEL related to medical problems. Seventy-five patients (12.6%) developed LEL. The incidence was high in patients with adjuvant radiotherapy (odds ratio, 3.47; 95% confidence interval, 2.086–5.788; P = 0.000), with 78.7% of the patients with LEL having developed the condition within 3 years after initial treatment.

Conclusions Adjuvant radiotherapy was significantly associated with development of LEL in women who had undergone radical surgery with lymphadenectomy for FIGO stage I to stage IIA cervical cancer. The possibility for the occurrence of LEL must be fully explained before treatment and patients should be provided with the appropriate preventive education. Further prospective studies are needed to confirm the incidence and risk factors for LEL.

  • Cervical cancer
  • Lymphedema
  • Incidence
  • Risk factor

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  • The authors declare that there are no conflicts of interest.