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Incidence and clinical presentation of lymphoedema in legs after endometrial cancer surgery – the lasec (lymphoedema after surgery of endometrial cancer) trial
  1. M Wedin1,
  2. K Stålberg2,
  3. J Marcickiewicz3,
  4. E Ahlner4,
  5. Å Åkesson5,
  6. P Rosenberg4 and
  7. P Kjølhede6
  1. 1Obstetrics and Gynecology, Linköping University Hospital, Linköping
  2. 2Women and Children’s Health, Uppsala University, Uppsala
  3. 3Varberg Central Hospital, Varberg
  4. 4Oncology, Linköping University Hospital, Linköping
  5. 5Obstetrics and Gynecology, Sahlgrenska Academy at University of Gothenburg, Gothenburg
  6. 6Obstetrics and Gynecology, Linköping University, Linköping, Linköping, Sweden


Introduction/Background Development of lymphoedema after treatment of endometrial cancer (EC), is still an unexplored area. The aim of this study was to determine the incidence and clinical presentation of lymphoedema of the legs after surgery for EC including pelvic and para-aortic lymphadenectomy one year postoperatively.

Methodology An observational multicentre study conducted in 14 centres in Sweden recruited 262 women. 130 women with high-risk early-stage EC underwent surgery including pelvic and para-aortic lymphadenectomy and 132 with low-risk EC had surgery without lymphadenectomy. Systematic leg circumference measurements enabling calculation of leg volumes were performed on four occasions; preoperatively, 4–6 weeks, 6 months, and 1 year postoperatively. Clinical evaluation of lymphoedema by a lymph therapist was conducted on the same occasion. A 10% increase in volume from baseline was categorised as lymphoedema.

Results The incidence of lymphoedema increased from 1.8% at the 4–6 weeks assessment to 15% one year postoperatively when lymphadenectomy had been performed. The corresponding figures in the non-lymphadenectomy group were 1.7% to 9.3%. There was no significant difference in incidence on any occasion between the lymphadenectomy and non-lymphadenectomy group (table 1). In women with more than 10% increase in leg volume, 60.7% was objectively clinically graded as normal by lymph therapists. The distribution of the occurrence of lymphoedema differed significantly between those who had less than 10% increase in leg volume and those who had ≥ 10% (table 2).

Abstract – Table 1

Increase in relative leg volume postoperatively from baseline categorized as > or <than 10%

Abstract – Table 2

Association between relative leg volume increase one year postoperatively and the lymph therapist objective evaluation according to Bruna et al.

Conclusion The incidence of lymphoedema in legs caused by lymphadenectomy after surgery for EC seemed to be low when assessed by leg volume measurements. Clinically grading of lymphoedema seemed to be underestimated by lymph therapists especially in those who had ≥ 10% increase in leg volume. This raise concerns about the methods of determining and reporting lymphoedema.

Disclosure Nothing to disclose.

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