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- Title
Lower Extremity Lymphedema in Gynecologic Cancer Patients: Propensity Score Matching Analysis of External Beam Radiation versus Brachytherapy.
- Authors
Chang, Won Ick; Kang, Hyun-Cheol; Wu, Hong-Gyun; Kim, Hak Jae; Jeon, Seung Hyuck; Lee, Maria; Kim, Hee Seung; Chung, Hyun Hoon; Kim, Jae Weon; Park, Noh Hyun; Song, Yong Sang; Seo, Kwan-Sik
- Abstract
The goal of this study is to compare the risk of lower extremity lymphedema (LEL) between pelvic external beam radiation therapy (EBRT) and vaginal brachytherapy, and to identify risk factors for LEL in gynecologic cancer patients treated with adjuvant radiation therapy (RT) after radical surgery. A total of 263 stage I–III gynecologic cancer patients who underwent adjuvant RT were retrospectively reviewed. One-to-one case-matched analysis was conducted with propensity scores generated from patient, tumor, and treatment characteristics. Using the risk factors found in this study, high- and low-risk groups were identified. With a median follow-up of 36.0 months, 35 of 263 (13.3%) patients developed LEL. In multivariate analysis, laparoscopic surgery (HR 2.548; p = 0.024), harvesting more than 30 pelvic lymph nodes (HR 2.246; p = 0.028), and para-aortic lymph node dissection (PALND, HR 2.305; p = 0.014) were identified as independent risk factors for LEL. After propensity score matching, the LEL incidence of the brachytherapy group was significantly lower than the EBRT group (p = 0.025). In conclusion, high-risk patients with risk factors such as laparoscopic surgery, harvesting more than 30 pelvic lymph nodes, PALND, and adjuvant pelvic EBRT require closer observation for LEL.
- Subjects
LYMPHEDEMA; CANCER patients; SURGICAL excision; FEMALE reproductive organ tumors; LAPAROSCOPIC surgery; LEG; LYMPH node surgery; MULTIVARIATE analysis; RADIOISOTOPE brachytherapy; RADIOTHERAPY; RISK assessment; RETROSPECTIVE studies; CASE-control method; DISEASE risk factors
- Publication
Cancers, 2019, Vol 11, Issue 10, p1471
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers11101471