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Clinical Lymphology and Lymphedema
Korean Society of Lymphology and Lymphedema

Clin. Lymphology Lymphedema 2016; 1(2):51-58

pISSN: 2508-190X

DOI: https://doi.org/10.67326/cll.2016.1.2.51

REVIEW ARTICLE

Lower Leg Lymphedema in Patients with Gynecologic Cancer

Jin Hwi Kim1, Yuyeon Jung2, Min Jong Song2, Yong Seok Lee2, Eun Kyung Park2, Keun Ho Lee3, Soo Young Hur3, Jong Sup Park3, Joo Hee Yoon4, Dong Choon Park4, Sung Jong Lee4,*
1Department of Obstetrics and Gynecology, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Uijeongbu
2Department of Obstetrics and Gynecology, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Daejeon
3Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul
4Department of Obstetrics and Gynecology, St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, Suwon, Korea
*Corresponding Author : Sung Jong Lee, MD, PhD, Department of Obstetrics and Gynecology, St. Vincent’s Hospital, The Catholic University of Korea College of Medicine, 93 Jungbu-daero, Paldal-gu, Suwon 16247, Korea, Tel: +82-31-249-8304, Fax: +82-31-254-7481, E-mail: orlando@catholic.ac.kr

ⓒ Copyright 2016 Korean Society of Lymphology and Lymphedema. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Oct 10, 2016; Accepted: Oct 24, 2016

Published Online: Oct 31, 2016

Abstract

Cervical, endometrial, and ovarian cancers are treated with surgery, radiation, or chemotherapy, depending on the treatment strategy. Gynecologic surgeons traditionally perform hysterectomy and pelvic lymphadenectomy with or without paraaortic lymphadenectomy in cervical, endometrial, and ovarian cancer. Lymphedema results from excess lymphatic fluid in the lymphatic system and interstitial space with diminished transport capacity. The main components of lymphatic fluid are interstitial water and solid filtrate, which only drain into the lymphatic system, not the arteriovenous capillary system. Primary lymphedema develops without a definitive cause, whereas, secondary lymphedema results from exogenous causes such as surgery, radiation, infection, and cancer metastasis. Based on the CTCAE v4.0, the degree of lymphedema was divided into three categories. Risk factors for lower leg lymphedema (LLL) in gynecologic cancer have included vulva cancer, radiotherapy, high number of lymph nodes dissected and BMI. In this paper, pathophysiology and risk factors for LLL in gynecologic cancer was evaluated based on the previous literature review. More interventional trials are necessary to decrease the development of LLL in gynecologic cancer.

Keywords: Lymphedema; Gynecologic cancer; Surgery; Radiation; Chemotherapy