Department of Urology and Urological Surgery, University Medical Centre Mannheim (UMM), Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Institute of Psychology, University of Heidelberg, Heidelberg, Germany.
Support Care Cancer. 2022 Feb;30(2):1303-1313. doi: 10.1007/s00520-021-06520-2. Epub 2021 Sep 3.
To explore men's onset and burden of lower limb lymphedema (LLL) after radical prostatectomy (RP) with pelvic lymph node dissection (PLND).
A cross-sectional survey-based study was conducted nation-wide and web-based in Germany. Part 1 included 15 multidisciplinary compiled questions with three questions from the Short Form 12 Health Survey (SF-12) and the WHO activity recommendation and part 2 included the validated German Lymph-ICF-Questionnaire (Lymph-ICF-LL). Subgroup comparisons and simple regression analyses were used to identify factors associated with therapy and burden of LLL, followed by multiple regression analyses to explain variance in impairment in the patients' daily life.
Fifty-four patients completed the survey. Median time of LLL-onset was reported with 2.0 (0.5-9.75) months after RP. Nineteen patients (35.2%) reported bilateral lymphedema, 28 (51.9%) the use of individually fitted compression stockings (CS), 25 (46.3%) of manual lymphatic drainage (LD), and 26 (48.1%) complete regression. The Lymph-ICF-LL revealed a higher total burden for patients with an active LLL compared to complete regression (total score: 25.5 vs. 11.9, p = 0.01) especially for "physical function" (28.3 vs. 12.9, p < 0.01) and "mental function" (26.2 vs. 6.7, p < 0.01). In multiple linear regression analysis, a higher BMI (β = 0.28), lower subjective general health (β = -0.48), and active lymphedema (β = 0.28) were significant predictors of higher reported impairments in the Lymph-ICF-LL, accounting for 45.4% of variance.
Men with LLL after RP with PLND report a significant burden in daily life. Basic therapy needs to be offered early. Postoperative onset of LLL is variable, which should be considered when assessing complications after RP.
探讨根治性前列腺切除术（RP）加盆腔淋巴结清扫术（PLND）后男性下肢淋巴水肿（LLL）的发病和负担。
本研究在德国全国范围内进行了一项基于横断面调查的研究，采用网络形式。第 1 部分包括 15 个多学科综合问题，其中 3 个问题来自 12 项简短健康调查（SF-12）和世界卫生组织活动建议，第 2 部分包括经过验证的德国淋巴国际功能分类问卷（Lymph-ICF-LL）。采用亚组比较和简单回归分析来确定与 LLL 治疗和负担相关的因素，然后采用多元回归分析来解释患者日常生活中受损的差异。
54 名患者完成了调查。报告的 LLL 发病中位时间为 RP 后 2.0（0.5-9.75）个月。19 名患者（35.2%）报告双侧淋巴水肿，28 名患者（51.9%）使用个人定制的压缩袜（CS），25 名患者（46.3%）接受手动淋巴引流（LD），26 名患者（48.1%）完全消退。Lymph-ICF-LL 显示活跃性 LLL 患者的总负担高于完全消退的患者（总分：25.5 比 11.9，p=0.01），特别是在“身体功能”（28.3 比 12.9，p<0.01）和“精神功能”（26.2 比 6.7，p<0.01）方面。多元线性回归分析显示，较高的 BMI（β=0.28）、较低的主观总体健康状况（β=-0.48）和活跃性淋巴水肿（β=0.28）是 Lymph-ICF-LL 报告中较高损伤的显著预测因素，占 45.4%的方差。
RP 加 PLND 后发生 LLL 的男性报告日常生活负担沉重。需要早期提供基本治疗。LLL 的术后发病时间存在差异，在评估 RP 后并发症时应考虑到这一点。
