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一项关于子宫内膜癌女性术后淋巴水肿发生率的前瞻性试点研究。

A prospective pilot study on the incidence of post-operative lymphedema in women with endometrial cancer.

作者信息

Hopp Elizabeth E, Osborne Janet L, Schneider Deborah K, Bojar Claudia J, Uyar Denise S

机构信息

Department of Obstetrics and Gynecology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Froedtert Medical College Lab Building (FMCLB) 258, Milwaukee, WI 53226, United States.

Carilion Clinic Gynecologic Oncology, 1 Riverside Circle, Suite 300, Roanoke, VA 24016, United States.

出版信息

Gynecol Oncol Rep. 2015 Dec 24;15:25-8. doi: 10.1016/j.gore.2015.12.002. eCollection 2016 Jan.

Abstract

To determine the incidence of lower-extremity lymphedema after surgical therapy including lymphadenectomy in endometrial cancer patients using standardized leg measurements. Also, to determine additional risk factors for the development of lymphedema and to study the effect of lymphedema on one's quality of life. In this prospective cohort study, patients with the diagnosis of endometrial cancer who were to undergo definitive surgical management were evaluated pre-operatively and followed post-operatively over the course of two years. Standardized leg measurements were performed by the same individuals at six time-points. Subjects also completed a standardized quality-of-life survey at each time-point. The incidence of lymphedema in 39 women with endometrial cancer using a standardized leg measurement protocol was 12.8% with lymphedema defined as a 20% increase in post-operative leg measurements. There was no significant association between the development of lymphedema and the number of pelvic or para-aortic lymph nodes removed, medical comorbidities, or surgical approach (p > 0.05). Of the five patients who met criteria for lymphedema, only one had worsening quality-of-life concerns post-operatively on the FACT-En, version 4, survey. This is the first prospective study using standardized leg measurements to calculate the incidence of post-operative lymphedema in endometrial cancer. Medical comorbidities, surgical approach, number of lymph nodes removed, and location of lymph nodes removed did not appear to affect the development of lymphedema in this cohort. A prospective, multicenter trial is needed to confirm these findings and to further assess the impact of lymphedema on one's quality of life.

摘要

采用标准化腿部测量方法,确定子宫内膜癌患者在包括淋巴结清扫术在内的手术治疗后下肢淋巴水肿的发生率。此外,确定淋巴水肿发生的其他风险因素,并研究淋巴水肿对患者生活质量的影响。在这项前瞻性队列研究中,对诊断为子宫内膜癌且即将接受确定性手术治疗的患者进行术前评估,并在术后两年内进行随访。由同一批人员在六个时间点进行标准化腿部测量。受试者在每个时间点还完成了一份标准化生活质量调查问卷。采用标准化腿部测量方案,39例子宫内膜癌女性患者中淋巴水肿的发生率为12.8%,淋巴水肿定义为术后腿部测量值增加20%。淋巴水肿的发生与盆腔或腹主动脉旁淋巴结切除数量、内科合并症或手术方式之间无显著关联(p>0.05)。在符合淋巴水肿标准的5例患者中,只有1例在术后FACT-En第4版调查问卷中生活质量问题恶化。这是第一项使用标准化腿部测量方法计算子宫内膜癌术后淋巴水肿发生率的前瞻性研究。在该队列中,内科合并症、手术方式、淋巴结切除数量和淋巴结切除部位似乎均不影响淋巴水肿的发生。需要进行一项前瞻性多中心试验来证实这些发现,并进一步评估淋巴水肿对患者生活质量的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6514/4750017/335a8b9f3b38/gr1.jpg

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