Lymphedema After Surgery for Endometrial Cancer: Prevalence, Risk Factors, and Quality of Life
Identifieur interne : 002890 ( Main/Exploration ); précédent : 002889; suivant : 002891Lymphedema After Surgery for Endometrial Cancer: Prevalence, Risk Factors, and Quality of Life
Auteurs : Kathleen J. Yost [États-Unis] ; Andrea L. Cheville [États-Unis] ; Mariam M. Al-Hilli [États-Unis] ; Andrea Mariani [États-Unis] ; Brigitte A. Barrette [États-Unis] ; Michaela E. Mcgree [États-Unis] ; Amy L. Weaver [États-Unis] ; Sean C. Dowdy [États-Unis]Source :
- Obstetrics and gynecology [ 0029-7844 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Défaillance cardiaque (), Enquêtes et questionnaires, Facteurs de risque, Femelle, Humains, Hystérectomie (effets indésirables), Indice de masse corporelle, Lymphadénectomie (effets indésirables), Lymphoedème (diagnostic), Lymphoedème (épidémiologie), Lymphoedème (étiologie), Membre inférieur, Prévalence, Qualité de vie, Sujet âgé, Tumeurs de l'endomètre (), Tumeurs de l'endomètre (radiothérapie), Études de suivi.
- MESH :
- diagnostic : Lymphoedème.
- effets indésirables : Hystérectomie, Lymphadénectomie.
- radiothérapie : Tumeurs de l'endomètre.
- épidémiologie : Lymphoedème.
- étiologie : Lymphoedème.
- Adulte d'âge moyen, Défaillance cardiaque, Enquêtes et questionnaires, Facteurs de risque, Femelle, Humains, Indice de masse corporelle, Membre inférieur, Prévalence, Qualité de vie, Sujet âgé, Tumeurs de l'endomètre, Études de suivi.
English descriptors
- KwdEn :
- Aged, Body Mass Index, Endometrial Neoplasms (radiotherapy), Endometrial Neoplasms (surgery), Female, Follow-Up Studies, Heart Failure (complications), Humans, Hysterectomy (adverse effects), Lower Extremity, Lymph Node Excision (adverse effects), Lymphedema (diagnosis), Lymphedema (epidemiology), Lymphedema (etiology), Middle Aged, Prevalence, Quality of Life, Risk Factors, Surveys and Questionnaires.
- MESH :
- adverse effects : Hysterectomy, Lymph Node Excision.
- complications : Heart Failure.
- diagnosis : Lymphedema.
- epidemiology : Lymphedema.
- etiology : Lymphedema.
- radiotherapy : Endometrial Neoplasms.
- surgery : Endometrial Neoplasms.
- Aged, Body Mass Index, Female, Follow-Up Studies, Humans, Lower Extremity, Middle Aged, Prevalence, Quality of Life, Risk Factors, Surveys and Questionnaires.
Abstract
To estimate lower-extremity lymphedema prevalence in patients surgically treated for endometrial cancer, identify predictors of lymphedema, and evaluate the effects of lymphedema on quality of life.
One thousand forty-eight consecutive patients who were operated on between 1999 and 2008 at Mayo Clinic were mailed a survey, which included our validated 13-item lymphedema screening questionnaire and two validated quality-of-life measures. Logistic regression models were fit to identify factors associated with prevalent lymphedema; a multivariable model was obtained using stepwise and backward variable selection methods. The relationship between lymphedema and obesity with each quality-of-life score was evaluated in a separate multivariable linear model.
There were 591 responders (56%) after exclusions. Our questionnaire revealed a previous self-reported lymphedema diagnosis in 103 (17%) patients and identified undiagnosed lymphedema in 175 (30%) (overall prevalence 47.0%; median 6.2 years follow-up). Lymphedema prevalence in patients treated with hysterectomy alone compared with lymphadenectomy was 36.1% and 52.3%, respectively (attributable risk, 23%). Lymphedema risk was not associated with the number of nodes removed or the extent of lymphadenectomy after adjusting for other factors. On multivariable analysis, higher BMI, congestive heart failure, performance of lymphadenectomy, and radiation therapy were associated with prevalent lymphedema. Multiple quality-of-life scores were worse in women with lymphedema.
The attributable risk of developing lower-extremity lymphedema was 23% for patients with endometrial cancer who underwent lymphadenectomy compared to hysterectomy alone, with an overall prevalence of 47%. Lymphedema was associated with reductions in multiple quality-of-life domains.
Url:
DOI: 10.1097/AOG.0000000000000372
PubMed: 25004343
PubMed Central: 4269467
Affiliations:
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Yost</name><affiliation wicri:level="1"><nlm:aff id="A5">Health Sciences Research, Mayo Clinic, Rochester, MN, 55902, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Health Sciences Research, Mayo Clinic, Rochester, MN, 55902</wicri:regionArea><wicri:noRegion>55902</wicri:noRegion></affiliation></author><author><name sortKey="Cheville, Andrea L" sort="Cheville, Andrea L" uniqKey="Cheville A" first="Andrea L." last="Cheville">Andrea L. Cheville</name><affiliation wicri:level="1"><nlm:aff id="A2">Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, 55902, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, 55902</wicri:regionArea><wicri:noRegion>55902</wicri:noRegion></affiliation></author><author><name sortKey="Al Hilli, Mariam M" sort="Al Hilli, Mariam M" uniqKey="Al Hilli M" first="Mariam M." last="Al-Hilli">Mariam M. Al-Hilli</name><affiliation wicri:level="1"><nlm:aff id="A1">Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55902, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55902</wicri:regionArea><wicri:noRegion>55902</wicri:noRegion></affiliation></author><author><name sortKey="Mariani, Andrea" sort="Mariani, Andrea" uniqKey="Mariani A" first="Andrea" last="Mariani">Andrea Mariani</name><affiliation wicri:level="1"><nlm:aff id="A1">Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55902, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55902</wicri:regionArea><wicri:noRegion>55902</wicri:noRegion></affiliation></author><author><name sortKey="Barrette, Brigitte A" sort="Barrette, Brigitte A" uniqKey="Barrette B" first="Brigitte A." last="Barrette">Brigitte A. 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Weaver</name><affiliation wicri:level="1"><nlm:aff id="A4">Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 55902, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, 55902</wicri:regionArea><wicri:noRegion>55902</wicri:noRegion></affiliation></author><author><name sortKey="Dowdy, Sean C" sort="Dowdy, Sean C" uniqKey="Dowdy S" first="Sean C." last="Dowdy">Sean C. Dowdy</name><affiliation wicri:level="1"><nlm:aff id="A1">Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55902, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gynecologic Surgery, Mayo Clinic, Rochester, MN, 55902</wicri:regionArea><wicri:noRegion>55902</wicri:noRegion></affiliation></author></analytic><series><title level="j">Obstetrics and gynecology</title><idno type="ISSN">0029-7844</idno><idno type="eISSN">1873-233X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Body Mass Index</term><term>Endometrial Neoplasms (radiotherapy)</term><term>Endometrial Neoplasms (surgery)</term><term>Female</term><term>Follow-Up Studies</term><term>Heart Failure (complications)</term><term>Humans</term><term>Hysterectomy (adverse effects)</term><term>Lower Extremity</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (etiology)</term><term>Middle Aged</term><term>Prevalence</term><term>Quality of Life</term><term>Risk Factors</term><term>Surveys and Questionnaires</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Défaillance cardiaque ()</term><term>Enquêtes et questionnaires</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Hystérectomie (effets indésirables)</term><term>Indice de masse corporelle</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (épidémiologie)</term><term>Lymphoedème (étiologie)</term><term>Membre inférieur</term><term>Prévalence</term><term>Qualité de vie</term><term>Sujet âgé</term><term>Tumeurs de l'endomètre ()</term><term>Tumeurs de l'endomètre (radiothérapie)</term><term>Études de suivi</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Hysterectomy</term><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Heart Failure</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Hystérectomie</term><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="radiotherapy" xml:lang="en"><term>Endometrial Neoplasms</term></keywords><keywords scheme="MESH" qualifier="radiothérapie" xml:lang="fr"><term>Tumeurs de l'endomètre</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Endometrial Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Body Mass Index</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Lower Extremity</term><term>Middle Aged</term><term>Prevalence</term><term>Quality of Life</term><term>Risk Factors</term><term>Surveys and Questionnaires</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Défaillance cardiaque</term><term>Enquêtes et questionnaires</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Membre inférieur</term><term>Prévalence</term><term>Qualité de vie</term><term>Sujet âgé</term><term>Tumeurs de l'endomètre</term><term>Études de suivi</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To estimate lower-extremity lymphedema prevalence in patients surgically treated for endometrial cancer, identify predictors of lymphedema, and evaluate the effects of lymphedema on quality of life.</p></sec><sec id="S2"><title>Methods</title><p id="P2">One thousand forty-eight consecutive patients who were operated on between 1999 and 2008 at Mayo Clinic were mailed a survey, which included our validated 13-item lymphedema screening questionnaire and two validated quality-of-life measures. Logistic regression models were fit to identify factors associated with prevalent lymphedema; a multivariable model was obtained using stepwise and backward variable selection methods. The relationship between lymphedema and obesity with each quality-of-life score was evaluated in a separate multivariable linear model.</p></sec><sec id="S3"><title>Results</title><p id="P3">There were 591 responders (56%) after exclusions. Our questionnaire revealed a previous self-reported lymphedema diagnosis in 103 (17%) patients and identified undiagnosed lymphedema in 175 (30%) (overall prevalence 47.0%; median 6.2 years follow-up). Lymphedema prevalence in patients treated with hysterectomy alone compared with lymphadenectomy was 36.1% and 52.3%, respectively (attributable risk, 23%). Lymphedema risk was not associated with the number of nodes removed or the extent of lymphadenectomy after adjusting for other factors. On multivariable analysis, higher BMI, congestive heart failure, performance of lymphadenectomy, and radiation therapy were associated with prevalent lymphedema. Multiple quality-of-life scores were worse in women with lymphedema.</p></sec><sec id="S4"><title>Conclusion</title><p id="P4">The attributable risk of developing lower-extremity lymphedema was 23% for patients with endometrial cancer who underwent lymphadenectomy compared to hysterectomy alone, with an overall prevalence of 47%. Lymphedema was associated with reductions in multiple quality-of-life domains.</p></sec></div></front></TEI><affiliations><list><country><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Yost, Kathleen J" sort="Yost, Kathleen J" uniqKey="Yost K" first="Kathleen J." last="Yost">Kathleen J. Yost</name></noRegion><name sortKey="Al Hilli, Mariam M" sort="Al Hilli, Mariam M" uniqKey="Al Hilli M" first="Mariam M." last="Al-Hilli">Mariam M. Al-Hilli</name><name sortKey="Barrette, Brigitte A" sort="Barrette, Brigitte A" uniqKey="Barrette B" first="Brigitte A." last="Barrette">Brigitte A. Barrette</name><name sortKey="Cheville, Andrea L" sort="Cheville, Andrea L" uniqKey="Cheville A" first="Andrea L." last="Cheville">Andrea L. Cheville</name><name sortKey="Dowdy, Sean C" sort="Dowdy, Sean C" uniqKey="Dowdy S" first="Sean C." last="Dowdy">Sean C. Dowdy</name><name sortKey="Mariani, Andrea" sort="Mariani, Andrea" uniqKey="Mariani A" first="Andrea" last="Mariani">Andrea Mariani</name><name sortKey="Mcgree, Michaela E" sort="Mcgree, Michaela E" uniqKey="Mcgree M" first="Michaela E" last="Mcgree">Michaela E. Mcgree</name><name sortKey="Weaver, Amy L" sort="Weaver, Amy L" uniqKey="Weaver A" first="Amy L." last="Weaver">Amy L. Weaver</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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