Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study
Identifieur interne : 000095 ( Pmc/Checkpoint ); précédent : 000094; suivant : 000096Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study
Auteurs : Kenji Kuroda [Japon] ; Yasuhiro Yamamoto [Japon] ; Manami Yanagisawa [Japon] ; Akira Kawata [Japon] ; Naoya Akiba [Japon] ; Kensuke Suzuki [Japon] ; Kazutoshi Naritaka [Japon]Source :
- BMC Women's Health [ 1472-6874 ] ; 2017.
Abstract
Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence.
Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk.
The cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m2 (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030–2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126–4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148–5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120–2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3–6) and low-risk (scores 0–2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440–3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9–62.1%] for the high-risk group and 28.9% [95% CI, 21.1–38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0.632 at 3 years, 0.640 at 5 years, and 0.637 at 10 years.
BMI ≥25 kg/m2, PLA + PALA, lymphocyst formation, and postoperative radiation therapy are significant predictive factors for LLL. Our prediction model may be useful for identifying patients at risk of LLL following lymphadenectomy. Providing an intensive therapeutic strategy for high-risk patients may help reduce the incidence of LLL and conserve the quality of life.
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DOI: 10.1186/s12905-017-0403-1
PubMed: 28743274
PubMed Central: 5526302
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study</title><author><name sortKey="Kuroda, Kenji" sort="Kuroda, Kenji" uniqKey="Kuroda K" first="Kenji" last="Kuroda">Kenji Kuroda</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Yamamoto, Yasuhiro" sort="Yamamoto, Yasuhiro" uniqKey="Yamamoto Y" first="Yasuhiro" last="Yamamoto">Yasuhiro Yamamoto</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Yanagisawa, Manami" sort="Yanagisawa, Manami" uniqKey="Yanagisawa M" first="Manami" last="Yanagisawa">Manami Yanagisawa</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Kawata, Akira" sort="Kawata, Akira" uniqKey="Kawata A" first="Akira" last="Kawata">Akira Kawata</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Akiba, Naoya" sort="Akiba, Naoya" uniqKey="Akiba N" first="Naoya" last="Akiba">Naoya Akiba</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Suzuki, Kensuke" sort="Suzuki, Kensuke" uniqKey="Suzuki K" first="Kensuke" last="Suzuki">Kensuke Suzuki</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Naritaka, Kazutoshi" sort="Naritaka, Kazutoshi" uniqKey="Naritaka K" first="Kazutoshi" last="Naritaka">Kazutoshi Naritaka</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28743274</idno><idno type="pmc">5526302</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5526302</idno><idno type="RBID">PMC:5526302</idno><idno type="doi">10.1186/s12905-017-0403-1</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000C97</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C97</idno><idno type="wicri:Area/Pmc/Curation">000C96</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C96</idno><idno type="wicri:Area/Pmc/Checkpoint">000095</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000095</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study</title><author><name sortKey="Kuroda, Kenji" sort="Kuroda, Kenji" uniqKey="Kuroda K" first="Kenji" last="Kuroda">Kenji Kuroda</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Yamamoto, Yasuhiro" sort="Yamamoto, Yasuhiro" uniqKey="Yamamoto Y" first="Yasuhiro" last="Yamamoto">Yasuhiro Yamamoto</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Yanagisawa, Manami" sort="Yanagisawa, Manami" uniqKey="Yanagisawa M" first="Manami" last="Yanagisawa">Manami Yanagisawa</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Kawata, Akira" sort="Kawata, Akira" uniqKey="Kawata A" first="Akira" last="Kawata">Akira Kawata</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Akiba, Naoya" sort="Akiba, Naoya" uniqKey="Akiba N" first="Naoya" last="Akiba">Naoya Akiba</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Suzuki, Kensuke" sort="Suzuki, Kensuke" uniqKey="Suzuki K" first="Kensuke" last="Suzuki">Kensuke Suzuki</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author><author><name sortKey="Naritaka, Kazutoshi" sort="Naritaka, Kazutoshi" uniqKey="Naritaka K" first="Kazutoshi" last="Naritaka">Kazutoshi Naritaka</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi</wicri:regionArea><wicri:noRegion>Yaizu-shi</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Women's Health</title><idno type="eISSN">1472-6874</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p id="Par1">Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence.</p></sec><sec><title>Methods</title><p id="Par2">Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk.</p></sec><sec><title>Results</title><p id="Par3">The cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m<sup>2</sup> (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030–2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126–4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148–5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120–2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3–6) and low-risk (scores 0–2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440–3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9–62.1%] for the high-risk group and 28.9% [95% CI, 21.1–38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0.632 at 3 years, 0.640 at 5 years, and 0.637 at 10 years.</p></sec><sec><title>Conclusion</title><p id="Par4">BMI ≥25 kg/m<sup>2</sup>, PLA + PALA, lymphocyst formation, and postoperative radiation therapy are significant predictive factors for LLL. Our prediction model may be useful for identifying patients at risk of LLL following lymphadenectomy. Providing an intensive therapeutic strategy for high-risk patients may help reduce the incidence of LLL and conserve the quality of life.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Ferlay, J" uniqKey="Ferlay J">J Ferlay</name></author><author><name sortKey="Soerjomataram, I" uniqKey="Soerjomataram I">I Soerjomataram</name></author><author><name sortKey="Dikshit, R" uniqKey="Dikshit R">R Dikshit</name></author><author><name sortKey="Eser, S" uniqKey="Eser S">S Eser</name></author><author><name sortKey="Mathers, C" uniqKey="Mathers C">C Mathers</name></author><author><name sortKey="Rebelo, M" uniqKey="Rebelo M">M Rebelo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koh, Wj" uniqKey="Koh W">WJ Koh</name></author><author><name sortKey="Greer, Be" uniqKey="Greer B">BE Greer</name></author><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author><author><name sortKey="Apte, Sm" uniqKey="Apte S">SM Apte</name></author><author><name sortKey="Campos, Sm" uniqKey="Campos S">SM Campos</name></author><author><name sortKey="Cho, Kr" uniqKey="Cho K">KR Cho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koh, Wj" uniqKey="Koh W">WJ Koh</name></author><author><name sortKey="Greer, Be" uniqKey="Greer B">BE Greer</name></author><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author><author><name sortKey="Apte, Sm" uniqKey="Apte S">SM Apte</name></author><author><name sortKey="Campos, Sm" uniqKey="Campos S">SM Campos</name></author><author><name sortKey="Chan, J" uniqKey="Chan J">J Chan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Morgan, Rj" uniqKey="Morgan R">RJ Morgan</name></author><author><name sortKey="Alvarez, Rd" uniqKey="Alvarez R">RD Alvarez</name></author><author><name sortKey="Armstrong, Dk" uniqKey="Armstrong D">DK Armstrong</name></author><author><name sortKey="Burger, Ra" uniqKey="Burger R">RA Burger</name></author><author><name sortKey="Chen, Lm" uniqKey="Chen L">LM Chen</name></author><author><name sortKey="Copeland, L" uniqKey="Copeland L">L Copeland</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Achouri, A" uniqKey="Achouri A">A Achouri</name></author><author><name sortKey="Huchon, C" uniqKey="Huchon C">C Huchon</name></author><author><name sortKey="Bats, As" uniqKey="Bats A">AS Bats</name></author><author><name sortKey="Bensaid, C" uniqKey="Bensaid C">C Bensaid</name></author><author><name sortKey="Nos, C" uniqKey="Nos C">C Nos</name></author><author><name sortKey="Lecuru, F" uniqKey="Lecuru F">F Lécuru</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Angioli, R" uniqKey="Angioli R">R Angioli</name></author><author><name sortKey="Plotti, F" uniqKey="Plotti F">F Plotti</name></author><author><name sortKey="Cafa, Ev" uniqKey="Cafa E">EV Cafà</name></author><author><name sortKey="Dugo, N" uniqKey="Dugo N">N Dugo</name></author><author><name sortKey="Capriglione, S" uniqKey="Capriglione S">S Capriglione</name></author><author><name sortKey="Terranova, C" uniqKey="Terranova C">C Terranova</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liao, S" uniqKey="Liao S">S Liao</name></author><author><name sortKey="Von Der Weid, Py" uniqKey="Von Der Weid P">PY von der Weid</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ghanta, S" uniqKey="Ghanta S">S Ghanta</name></author><author><name sortKey="Cuzzone, Da" uniqKey="Cuzzone D">DA Cuzzone</name></author><author><name sortKey="Torrisi, Js" uniqKey="Torrisi J">JS Torrisi</name></author><author><name sortKey="Albano, Nj" uniqKey="Albano N">NJ Albano</name></author><author><name sortKey="Joseph, Wj" uniqKey="Joseph W">WJ Joseph</name></author><author><name sortKey="Savetsky, Il" uniqKey="Savetsky I">IL Savetsky</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Biglia, N" uniqKey="Biglia N">N Biglia</name></author><author><name sortKey="Librino, A" uniqKey="Librino A">A Librino</name></author><author><name sortKey="Ottino, Mc" uniqKey="Ottino M">MC Ottino</name></author><author><name sortKey="Panuccio, E" uniqKey="Panuccio E">E Panuccio</name></author><author><name sortKey="Daniele, A" uniqKey="Daniele A">A Daniele</name></author><author><name sortKey="Chahin, A" uniqKey="Chahin A">A Chahin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tashiro, K" uniqKey="Tashiro K">K Tashiro</name></author><author><name sortKey="Yamashita, S" uniqKey="Yamashita S">S Yamashita</name></author><author><name sortKey="Saito, T" uniqKey="Saito T">T Saito</name></author><author><name sortKey="Iida, T" uniqKey="Iida T">T Iida</name></author><author><name sortKey="Koshima, I" uniqKey="Koshima I">I Koshima</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zaleska, M" uniqKey="Zaleska M">M Zaleska</name></author><author><name sortKey="Olszewski, Wl" uniqKey="Olszewski W">WL Olszewski</name></author><author><name sortKey="Durlik, M" uniqKey="Durlik M">M Durlik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ohba, Y" uniqKey="Ohba Y">Y Ohba</name></author><author><name sortKey="Todo, Y" uniqKey="Todo Y">Y Todo</name></author><author><name sortKey="Kobayashi, N" uniqKey="Kobayashi N">N Kobayashi</name></author><author><name sortKey="Kaneuchi, M" uniqKey="Kaneuchi M">M Kaneuchi</name></author><author><name sortKey="Watari, H" uniqKey="Watari H">H Watari</name></author><author><name sortKey="Takeda, M" uniqKey="Takeda M">M Takeda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hareyama, H" uniqKey="Hareyama H">H Hareyama</name></author><author><name sortKey="Hada, K" uniqKey="Hada K">K Hada</name></author><author><name sortKey="Goto, K" uniqKey="Goto K">K Goto</name></author><author><name sortKey="Watanabe, S" uniqKey="Watanabe S">S Watanabe</name></author><author><name sortKey="Hakoyama, M" uniqKey="Hakoyama M">M Hakoyama</name></author><author><name sortKey="Oku, K" uniqKey="Oku K">K Oku</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Graf, N" uniqKey="Graf N">N Graf</name></author><author><name sortKey="Rufibach, K" uniqKey="Rufibach K">K Rufibach</name></author><author><name sortKey="Schmidt, Am" uniqKey="Schmidt A">AM Schmidt</name></author><author><name sortKey="Fehr, M" uniqKey="Fehr M">M Fehr</name></author><author><name sortKey="Fink, D" uniqKey="Fink D">D Fink</name></author><author><name sortKey="Baege, Ac" uniqKey="Baege A">AC Baege</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, M" uniqKey="Kim M">M Kim</name></author><author><name sortKey="Suh, Dh" uniqKey="Suh D">DH Suh</name></author><author><name sortKey="Yang, Ej" uniqKey="Yang E">EJ Yang</name></author><author><name sortKey="Lim, Mc" uniqKey="Lim M">MC Lim</name></author><author><name sortKey="Choi, Jy" uniqKey="Choi J">JY Choi</name></author><author><name sortKey="Kim, K" uniqKey="Kim K">K Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kizer, Nt" uniqKey="Kizer N">NT Kizer</name></author><author><name sortKey="Thaker, Ph" uniqKey="Thaker P">PH Thaker</name></author><author><name sortKey="Gao, F" uniqKey="Gao F">F Gao</name></author><author><name sortKey="Zighelboim, I" uniqKey="Zighelboim I">I Zighelboim</name></author><author><name sortKey="Powell, Ma" uniqKey="Powell M">MA Powell</name></author><author><name sortKey="Rader, Js" uniqKey="Rader J">JS Rader</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Todo, Y" uniqKey="Todo Y">Y Todo</name></author><author><name sortKey="Yamamoto, R" uniqKey="Yamamoto R">R Yamamoto</name></author><author><name sortKey="Minobe, S" uniqKey="Minobe S">S Minobe</name></author><author><name sortKey="Suzuki, Y" uniqKey="Suzuki Y">Y Suzuki</name></author><author><name sortKey="Takeshi, U" uniqKey="Takeshi U">U Takeshi</name></author><author><name sortKey="Nakatani, M" uniqKey="Nakatani M">M Nakatani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, M" uniqKey="Kim M">M Kim</name></author><author><name sortKey="Kim, Sw" uniqKey="Kim S">SW Kim</name></author><author><name sortKey="Lee, Su" uniqKey="Lee S">SU Lee</name></author><author><name sortKey="Lee, Nk" uniqKey="Lee N">NK Lee</name></author><author><name sortKey="Jung, Sy" uniqKey="Jung S">SY Jung</name></author><author><name sortKey="Kim, Th" uniqKey="Kim T">TH Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bevilacqua, Jl" uniqKey="Bevilacqua J">JL Bevilacqua</name></author><author><name sortKey="Kattan, Mw" uniqKey="Kattan M">MW Kattan</name></author><author><name sortKey="Changhong, Y" uniqKey="Changhong Y">Y Changhong</name></author><author><name sortKey="Koifman, S" uniqKey="Koifman S">S Koifman</name></author><author><name sortKey="Mattos, Ie" uniqKey="Mattos I">IE Mattos</name></author><author><name sortKey="Koifman, Rj" uniqKey="Koifman R">RJ Koifman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, L" uniqKey="Kim L">L Kim</name></author><author><name sortKey="Jeon, Jy" uniqKey="Jeon J">JY Jeon</name></author><author><name sortKey="Sung, Iy" uniqKey="Sung I">IY Sung</name></author><author><name sortKey="Jeong, Sy" uniqKey="Jeong S">SY Jeong</name></author><author><name sortKey="Do, Jh" uniqKey="Do J">JH Do</name></author><author><name sortKey="Kim, Hj" uniqKey="Kim H">HJ Kim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Soran, A" uniqKey="Soran A">A Soran</name></author><author><name sortKey="Menekse, E" uniqKey="Menekse E">E Menekse</name></author><author><name sortKey="Girgis, M" uniqKey="Girgis M">M Girgis</name></author><author><name sortKey="Degore, L" uniqKey="Degore L">L DeGore</name></author><author><name sortKey="Johnson, R" uniqKey="Johnson R">R Johnson</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kanda, Y" uniqKey="Kanda Y">Y Kanda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ridner, Sh" uniqKey="Ridner S">SH Ridner</name></author><author><name sortKey="Dietrich, Ms" uniqKey="Dietrich M">MS Dietrich</name></author><author><name sortKey="Stewart, Br" uniqKey="Stewart B">BR Stewart</name></author><author><name sortKey="Armer, Jm" uniqKey="Armer J">JM Armer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Helyer, Lk" uniqKey="Helyer L">LK Helyer</name></author><author><name sortKey="Varnic, M" uniqKey="Varnic M">M Varnic</name></author><author><name sortKey="Le, Lw" uniqKey="Le L">LW Le</name></author><author><name sortKey="Leong, W" uniqKey="Leong W">W Leong</name></author><author><name sortKey="Mccready, D" uniqKey="Mccready D">D McCready</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Greene, Ak" uniqKey="Greene A">AK Greene</name></author><author><name sortKey="Grant, Fd" uniqKey="Grant F">FD Grant</name></author><author><name sortKey="Slavin, Sa" uniqKey="Slavin S">SA Slavin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nugent, Ek" uniqKey="Nugent E">EK Nugent</name></author><author><name sortKey="Hoff, Jt" uniqKey="Hoff J">JT Hoff</name></author><author><name sortKey="Gao, F" uniqKey="Gao F">F Gao</name></author><author><name sortKey="Massad, Ls" uniqKey="Massad L">LS Massad</name></author><author><name sortKey="Case, A" uniqKey="Case A">A Case</name></author><author><name sortKey="Zighelboim, I" uniqKey="Zighelboim I">I Zighelboim</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gunderson, Cc" uniqKey="Gunderson C">CC Gunderson</name></author><author><name sortKey="Java, J" uniqKey="Java J">J Java</name></author><author><name sortKey="Moore, Kn" uniqKey="Moore K">KN Moore</name></author><author><name sortKey="Walker, Jl" uniqKey="Walker J">JL Walker</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mctiernan, A" uniqKey="Mctiernan A">A McTiernan</name></author><author><name sortKey="Irwin, M" uniqKey="Irwin M">M Irwin</name></author><author><name sortKey="Vongruenigen, V" uniqKey="Vongruenigen V">V Vongruenigen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hareyama, H" uniqKey="Hareyama H">H Hareyama</name></author><author><name sortKey="Ito, K" uniqKey="Ito K">K Ito</name></author><author><name sortKey="Hada, K" uniqKey="Hada K">K Hada</name></author><author><name sortKey="Uchida, A" uniqKey="Uchida A">A Uchida</name></author><author><name sortKey="Hayakashi, Y" uniqKey="Hayakashi Y">Y Hayakashi</name></author><author><name sortKey="Hirayama, E" uniqKey="Hirayama E">E Hirayama</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hoffman, Ms" uniqKey="Hoffman M">MS Hoffman</name></author><author><name sortKey="Parsons, M" uniqKey="Parsons M">M Parsons</name></author><author><name sortKey="Gunasekaran, S" uniqKey="Gunasekaran S">S Gunasekaran</name></author><author><name sortKey="Cavanagh, D" uniqKey="Cavanagh D">D Cavanagh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jewell, El" uniqKey="Jewell E">EL Jewell</name></author><author><name sortKey="Huang, Jj" uniqKey="Huang J">JJ Huang</name></author><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author><author><name sortKey="Gardner, Gj" uniqKey="Gardner G">GJ Gardner</name></author><author><name sortKey="Brown, Cl" uniqKey="Brown C">CL Brown</name></author><author><name sortKey="Sonoda, Y" uniqKey="Sonoda Y">Y Sonoda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ballester, M" uniqKey="Ballester M">M Ballester</name></author><author><name sortKey="Dubernard, G" uniqKey="Dubernard G">G Dubernard</name></author><author><name sortKey="Lecuru, F" uniqKey="Lecuru F">F Lécuru</name></author><author><name sortKey="Heitz, D" uniqKey="Heitz D">D Heitz</name></author><author><name sortKey="Mathevet, P" uniqKey="Mathevet P">P Mathevet</name></author><author><name sortKey="Marret, H" uniqKey="Marret H">H Marret</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beesley, Vl" uniqKey="Beesley V">VL Beesley</name></author><author><name sortKey="Rowlands, Ij" uniqKey="Rowlands I">IJ Rowlands</name></author><author><name sortKey="Hayes, Sc" uniqKey="Hayes S">SC Hayes</name></author><author><name sortKey="Janda, M" uniqKey="Janda M">M Janda</name></author><author><name sortKey="O Ourke, P" uniqKey="O Ourke P">P O’Rourke</name></author><author><name sortKey="Marquart, L" uniqKey="Marquart L">L Marquart</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tiwari, P" uniqKey="Tiwari P">P Tiwari</name></author><author><name sortKey="Coriddi, M" uniqKey="Coriddi M">M Coriddi</name></author><author><name sortKey="Salani, R" uniqKey="Salani R">R Salani</name></author><author><name sortKey="Povoski, Sp" uniqKey="Povoski S">SP Povoski</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Falcetta, Fs" uniqKey="Falcetta F">FS Falcetta</name></author><author><name sortKey="Medeiros, Lr" uniqKey="Medeiros L">LR Medeiros</name></author><author><name sortKey="Edelweiss, Mi" uniqKey="Edelweiss M">MI Edelweiss</name></author><author><name sortKey="Pohlmann, Pr" uniqKey="Pohlmann P">PR Pohlmann</name></author><author><name sortKey="Stein, At" uniqKey="Stein A">AT Stein</name></author><author><name sortKey="Rosa, Dd" uniqKey="Rosa D">DD Rosa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Takekuma, M" uniqKey="Takekuma M">M Takekuma</name></author><author><name sortKey="Kasamatsu, Y" uniqKey="Kasamatsu Y">Y Kasamatsu</name></author><author><name sortKey="Kado, N" uniqKey="Kado N">N Kado</name></author><author><name sortKey="Kuji, S" uniqKey="Kuji S">S Kuji</name></author><author><name sortKey="Tanaka, A" uniqKey="Tanaka A">A Tanaka</name></author><author><name sortKey="Takahashi, N" uniqKey="Takahashi N">N Takahashi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Achouri, A" uniqKey="Achouri A">A Achouri</name></author><author><name sortKey="Huchon, C" uniqKey="Huchon C">C Huchon</name></author><author><name sortKey="Bats, As" uniqKey="Bats A">AS Bats</name></author><author><name sortKey="Bensaid, C" uniqKey="Bensaid C">C Bensaïd</name></author><author><name sortKey="Nos, C" uniqKey="Nos C">C Nos</name></author><author><name sortKey="Lecuru, F" uniqKey="Lecuru F">F Lécuru</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Komiyama, S" uniqKey="Komiyama S">S Komiyama</name></author><author><name sortKey="Takeya, C" uniqKey="Takeya C">C Takeya</name></author><author><name sortKey="Takahashi, R" uniqKey="Takahashi R">R Takahashi</name></author><author><name sortKey="Yamamoto, Y" uniqKey="Yamamoto Y">Y Yamamoto</name></author><author><name sortKey="Kubushiro, K" uniqKey="Kubushiro K">K Kubushiro</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nagai, A" uniqKey="Nagai A">A Nagai</name></author><author><name sortKey="Shibamoto, Y" uniqKey="Shibamoto Y">Y Shibamoto</name></author><author><name sortKey="Ogawa, K" uniqKey="Ogawa K">K Ogawa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lasinski, Bb" uniqKey="Lasinski B">BB Lasinski</name></author><author><name sortKey="Mckillip Thrift, K" uniqKey="Mckillip Thrift K">K McKillip Thrift</name></author><author><name sortKey="Squire, D" uniqKey="Squire D">D Squire</name></author><author><name sortKey="Austin, Mk" uniqKey="Austin M">MK Austin</name></author><author><name sortKey="Smith, Km" uniqKey="Smith K">KM Smith</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Torres Lacomba, M" uniqKey="Torres Lacomba M">M Torres Lacomba</name></author><author><name sortKey="Yuste Sanchez, Mj" uniqKey="Yuste Sanchez M">MJ Yuste Sánchez</name></author><author><name sortKey="Zapico Go I, A" uniqKey="Zapico Go I A">A Zapico Goñi</name></author><author><name sortKey="Prieto Merino, D" uniqKey="Prieto Merino D">D Prieto Merino</name></author><author><name sortKey="Mayoral Del Moral, O" uniqKey="Mayoral Del Moral O">O Mayoral del Moral</name></author><author><name sortKey="Cerezo Tellez, E" uniqKey="Cerezo Tellez E">E Cerezo Téllez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schmitz, Kh" uniqKey="Schmitz K">KH Schmitz</name></author><author><name sortKey="Ahmed, Rl" uniqKey="Ahmed R">RL Ahmed</name></author><author><name sortKey="Troxel, Ab" uniqKey="Troxel A">AB Troxel</name></author><author><name sortKey="Cheville, A" uniqKey="Cheville A">A Cheville</name></author><author><name sortKey="Lewis Grant, L" uniqKey="Lewis Grant L">L Lewis-Grant</name></author><author><name sortKey="Smith, R" uniqKey="Smith R">R Smith</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cheng, Mh" uniqKey="Cheng M">MH Cheng</name></author><author><name sortKey="Huang, Jj" uniqKey="Huang J">JJ Huang</name></author><author><name sortKey="Nguyen, Dh" uniqKey="Nguyen D">DH Nguyen</name></author><author><name sortKey="Saint Cyr, M" uniqKey="Saint Cyr M">M Saint-Cyr</name></author><author><name sortKey="Zenn, Mr" uniqKey="Zenn M">MR Zenn</name></author><author><name sortKey="Tan, Bk" uniqKey="Tan B">BK Tan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bergmark, K" uniqKey="Bergmark K">K Bergmark</name></author><author><name sortKey="Avall Lundqvist, E" uniqKey="Avall Lundqvist E">E Avall-Lundqvist</name></author><author><name sortKey="Dickman, Pw" uniqKey="Dickman P">PW Dickman</name></author><author><name sortKey="Henningsohn, L" uniqKey="Henningsohn L">L Henningsohn</name></author><author><name sortKey="Steineck, G" uniqKey="Steineck G">G Steineck</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Jh" uniqKey="Kim J">JH Kim</name></author><author><name sortKey="Choi, Jh" uniqKey="Choi J">JH Choi</name></author><author><name sortKey="Ki, Ey" uniqKey="Ki E">EY Ki</name></author><author><name sortKey="Lee, Sj" uniqKey="Lee S">SJ Lee</name></author><author><name sortKey="Yoon, Jh" uniqKey="Yoon J">JH Yoon</name></author><author><name sortKey="Lee, Kh" uniqKey="Lee K">KH Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Finnane, A" uniqKey="Finnane A">A Finnane</name></author><author><name sortKey="Hayes, Sc" uniqKey="Hayes S">SC Hayes</name></author><author><name sortKey="Obermair, A" uniqKey="Obermair A">A Obermair</name></author><author><name sortKey="Janda, M" uniqKey="Janda M">M Janda</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Czerniec, Sa" uniqKey="Czerniec S">SA Czerniec</name></author><author><name sortKey="Ward, Lc" uniqKey="Ward L">LC Ward</name></author><author><name sortKey="Lee, Mj" uniqKey="Lee M">MJ Lee</name></author><author><name sortKey="Refshauge, Km" uniqKey="Refshauge K">KM Refshauge</name></author><author><name sortKey="Beith, J" uniqKey="Beith J">J Beith</name></author><author><name sortKey="Kilbreath, Sl" uniqKey="Kilbreath S">SL Kilbreath</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Paskett, Ed" uniqKey="Paskett E">ED Paskett</name></author><author><name sortKey="Dean, Ja" uniqKey="Dean J">JA Dean</name></author><author><name sortKey="Oliveri, Jm" uniqKey="Oliveri J">JM Oliveri</name></author><author><name sortKey="Harrop, Jp" uniqKey="Harrop J">JP Harrop</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gaw, R" uniqKey="Gaw R">R Gaw</name></author><author><name sortKey="Box, R" uniqKey="Box R">R Box</name></author><author><name sortKey="Cornish, B" uniqKey="Cornish B">B Cornish</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ward, L" uniqKey="Ward L">L Ward</name></author><author><name sortKey="Winall, A" uniqKey="Winall A">A Winall</name></author><author><name sortKey="Isenring, E" uniqKey="Isenring E">E Isenring</name></author><author><name sortKey="Hills, A" uniqKey="Hills A">A Hills</name></author><author><name sortKey="Czerniec, S" uniqKey="Czerniec S">S Czerniec</name></author><author><name sortKey="Dylke, E" uniqKey="Dylke E">E Dylke</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Womens Health</journal-id><journal-id journal-id-type="iso-abbrev">BMC Womens Health</journal-id><journal-title-group><journal-title>BMC Women's Health</journal-title></journal-title-group><issn pub-type="epub">1472-6874</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28743274</article-id><article-id pub-id-type="pmc">5526302</article-id><article-id pub-id-type="publisher-id">403</article-id><article-id pub-id-type="doi">10.1186/s12905-017-0403-1</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">http://orcid.org/0000-0001-9960-9673</contrib-id><name><surname>Kuroda</surname><given-names>Kenji</given-names></name><address><phone>+81-54-623-3111</phone><email>kenji.kuroda@hospital.yaizu.shizuoka.jp</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Yamamoto</surname><given-names>Yasuhiro</given-names></name><address><email>yamamotoyasuhiro77@gmail.com</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Yanagisawa</surname><given-names>Manami</given-names></name><address><email>manami.yanagisawa@hospital.yaizu.shizuoka.jp</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Kawata</surname><given-names>Akira</given-names></name><address><email>akira.kawata@hospital.yaizu.shizuoka.jp</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Akiba</surname><given-names>Naoya</given-names></name><address><email>naoya.akiba@hospital.yaizu.shizuoka.jp</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Suzuki</surname><given-names>Kensuke</given-names></name><address><email>kensuke.suzuki@hospital.yaizu.shizuoka.jp</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Naritaka</surname><given-names>Kazutoshi</given-names></name><address><email>kazutoshi.naritaka@hospital.yaizu.shizuoka.jp</email></address><xref ref-type="aff" rid="Aff1"></xref></contrib><aff id="Aff1">Department of Obstetrics and Gynecology, Yaizu City Hospital, 1000, Dobara, Yaizu-shi, 425-8505 Japan</aff></contrib-group><pub-date pub-type="epub"><day>25</day><month>7</month><year>2017</year></pub-date><pub-date pub-type="pmc-release"><day>25</day><month>7</month><year>2017</year></pub-date><pub-date pub-type="collection"><year>2017</year></pub-date><volume>17</volume><elocation-id>50</elocation-id><history><date date-type="received"><day>2</day><month>5</month><year>2016</year></date><date date-type="accepted"><day>19</day><month>7</month><year>2017</year></date></history><permissions><copyright-statement>© The Author(s). 2017</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p id="Par1">Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence.</p></sec><sec><title>Methods</title><p id="Par2">Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk.</p></sec><sec><title>Results</title><p id="Par3">The cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m<sup>2</sup> (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030–2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126–4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148–5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120–2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3–6) and low-risk (scores 0–2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440–3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9–62.1%] for the high-risk group and 28.9% [95% CI, 21.1–38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0.632 at 3 years, 0.640 at 5 years, and 0.637 at 10 years.</p></sec><sec><title>Conclusion</title><p id="Par4">BMI ≥25 kg/m<sup>2</sup>, PLA + PALA, lymphocyst formation, and postoperative radiation therapy are significant predictive factors for LLL. Our prediction model may be useful for identifying patients at risk of LLL following lymphadenectomy. Providing an intensive therapeutic strategy for high-risk patients may help reduce the incidence of LLL and conserve the quality of life.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Lower limb lymphedema</kwd><kwd>Lymph node dissection</kwd><kwd>Lymphocyst</kwd><kwd>Body mass index</kwd><kwd>Prediction model</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2017</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Kuroda, Kenji" sort="Kuroda, Kenji" uniqKey="Kuroda K" first="Kenji" last="Kuroda">Kenji Kuroda</name></noRegion><name sortKey="Akiba, Naoya" sort="Akiba, Naoya" uniqKey="Akiba N" first="Naoya" last="Akiba">Naoya Akiba</name><name sortKey="Kawata, Akira" sort="Kawata, Akira" uniqKey="Kawata A" first="Akira" last="Kawata">Akira Kawata</name><name sortKey="Naritaka, Kazutoshi" sort="Naritaka, Kazutoshi" uniqKey="Naritaka K" first="Kazutoshi" last="Naritaka">Kazutoshi Naritaka</name><name sortKey="Suzuki, Kensuke" sort="Suzuki, Kensuke" uniqKey="Suzuki K" first="Kensuke" last="Suzuki">Kensuke Suzuki</name><name sortKey="Yamamoto, Yasuhiro" sort="Yamamoto, Yasuhiro" uniqKey="Yamamoto Y" first="Yasuhiro" last="Yamamoto">Yasuhiro Yamamoto</name><name sortKey="Yanagisawa, Manami" sort="Yanagisawa, Manami" uniqKey="Yanagisawa M" first="Manami" last="Yanagisawa">Manami Yanagisawa</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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