Skip to main content

Table 3 Incidence and risk factors of edema and/or lymphedema of lower leg after treatment of ovarian cancer

From: Lower extremity edema in patients with early ovarian cancer

First author Year Study design N. of OC patients (N. of total GC patients) Stage Diagnostic criteria Incidence (%) Risk factor for LEE/LLL Comment
Ryan M. 2003 CQ & MRR 141 (487) NA · Diagnosed LLL · 7.1% (10/141) in OC · MTFOTL: 3, 6, 12, and 60 months in 53, 18, 13, and 16% of the patients with GC.
· 18.3% (89/487) in all GC
· 62.2% (28/45) after GLND · Highest rate of LLL after GLND (50–62.2%).
· 50.0% (47/233) after GLND + PLND
Panici PB. 2005 Multi-center Italian RCT 427 III, 406 (95.1%) · Diagnosed LLL · 6.5% (14/216) vs. 0% (0/211) in SL vs. LNS · SL compared to LNS · Improvement of SL on PFS, but not OS.
IV, 21 (4.9%)
Magginoi A. 2006 Multi-center Italian RCT 268 I, 192 (72.7%) · Diagnosed LLL · 5.8% (8/138) vs. 0% (0/130) in SL vs. LNS · SL compared to LNS · No improvement of SL on PFS and OS.
II, 72 (27.3%)
Beesley V. 2007 PRO via mail 234 (802) NA · PRO - LEE · LEE, 15.8% (37/234) · Lowest incidence (4.7%) of LLL among GC
· Diagnosed LLL
· LLL, 4.7% (11/234) · BMI is not risk factor.
Tanaka T. 2007 CQ & MRR 21 (184) I–II, 17 (81%) · PRO - LEE · 41.7% (5/12) in RC vs. · RC is not risk factor. This should be investigated again in larger number of patients.
III–IV, 4 (19%)  · 22.2% (2/9) in non-RC
Tada H. 2009 Multi-center Japanese Retrospective 135 (694) I–II, 75 (55.6%) · Diagnosed & symptomatic LLL · 20.7% (28/135) · RT, OR 1.79 (95%CI, 1.20-2.68) · MTFOTL: 4.6 (0.1–40.2) months
· LLL, 25.8 vs. 31.7% in PALND(-) vs. (+)
III–IV, 60 (44.4%)
Matsuo K. 2011 Retrospective 276 I–II, 43 (15.6%) · MRR · LEE, 6.5% (18/276) · LEE at initial diagnosis is an important on PFS (4.9 vs. 15.3 months) and OS (5.9 and 49.1 months).
III–IV, 233 (84.5%)
· LEE is the 14th symptoms.
Karlan BY. 2012 RCT 161 Recurrent OC · Peripheral edema · LEE, 51-71% vs. 22% in AMG 386* vs. Control AMG386 administered patients · LEE, 51 & 71% (AMG 386 3 & 10 mg/kg QW with paclitaxel QW) vs. 22% in AMG 386* vs. Control (weekly paclitaxel (80 mg/m2 QW)
Achouri A. 2012 Retrospective 36 (88) NA · Diagnosed LLL · 5.6% (2/36) · Postoperative drainage, OR 0.13 (95%CI, 0.02-0.69) · Incidence of LLL, 11.4% and 23.5% in EC and CC.
· BMI, surgical approach (laparoscopy and laparotomy), PALND, SPOL, number of LND is not risk factor for LLL
Lim MC. 2013 Current study CQ & MRR 71 I, 52 (73.3%) · PRO - LEE · 40.8% (29/71) · MTFOTL: <1, 3, 6, and 12 months in 63,18.5, 7.4, and 3.7%
II, 19 (26.7%)
· Median duration of LEE: <6, 12, 60, and ≥60 in 27.3, 9.1, 22.7, and 40.9%
  1. BMI, body mass index; CC, cervical cancer; CQ, cross-sectional questionnaire; EC, endometrial cancer; GC, gynecologic cancer; GLND, groin lymph node dissection; LEE, lower extremity edema; LLL, lower leg lymphedema; LND, lymph node dissection; LNS, lymph node sampling; MRR, medical record review; MTFOTL, median time from operation to lower extremity edema; N, number; NA, not available; OC, ovarian cancer; OS, overall survival; PALN, paraaortic lymph node; PALND, paraaortic lymph node dissection; PFS, progression free survival; PLN, pelvic lymph node; PLND, pelvic lymph node dissection; PRO, patient reported outcomes; QW, once weekly; RC, retroperitoneal closure; RCT, randomized trial; RT, radiotherapy; SL, systemic pelvic and aortic lymph node dissection; SPOL, symptomatic postoperative lymphocele.
  2. *AMG386, an investigational peptide-Fc fusion protein that neutralizes the interaction between the Tie2 receptor and angiopoietin-1/2.