Risk factors for lower extremity lymphedema after cervical cancer treatment: a systematic review and meta-analysis

作者：Hong-Yuan Hu, Mingru Fu, Xiujin Huang, Ju Huang, Jinniao Gao · 发表于：Translational Cancer Research · 年份：2022 · DOI：10.21037/tcr-22-1256 · 被引用次数：24 · 研究领域：Lymphatic System and Diseases、Lymphatic Disorders and Treatments、Systemic Sclerosis and Related Diseases

Background: The main risk factors for the development of lower extremity lymphedema after cervical cancer treatment are controversial. Our aim was to evaluate the main risk factors of lower extremity lymphedema after cervical cancer treatment. Methods: We searched the English database PubMed, Embase, Medline, Central and the Chinese database CNKI to obtain relevant studies. Inclusion criteria: (I) the subjects were cervical cancer patients receiving treatment; (II) cohort studies or case-control studies; (III) exposure factors were not limited; (IV) the outcome was lower extremity lymphedema after treatment; (V) the odds ratio (OR) value and 95% confidence interval of exposure factors can be obtained. The chi-square test was used to test for heterogeneity. The Egger test was used to test for publication bias. OR (95% CI) was calculated using inverse variance. Results: A total of 12 retrospective studies with a total of 3,401 patients were included in this literature review. The incidence of lower extremity lymphedema after cervical cancer treatment was between 12.6% and 43.1%. Meta-analysis results demonstrated that the main risk factors were: body mass index (BMI) (OR =1.37, 95% CI: 1.10-1.71, P=0.005), age (OR =1.68, 95% CI: 1.07-2.64, P=0.02), International Federation of Gynecology and Obstetrics (FIGO) stage (OR =1.50, 95% CI: 1.24-1.82, P<0.001), radiotherapy (OR =2.87, 95% CI: 1.71-4.82, P<0.001), lymph node (LN) dissection (OR =3.24, 95% CI: 1.44-7.31, P=0.005), and th...