The Prevalence, Incidence, and Quality-of-Life Impact of Lymphedema After Treatment for Vulvar or Vaginal Cancer

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Abstract

Background:

Incidence of lymphedema appears to be higher in women with vulvar/vaginal cancer than in those with other forms of gynecological cancer. The objective of this work was to determine the point prevalence and incidence of lymphedema in women with vulvar/vaginal cancer and to describe symptom burden and quality of life (QOL).

Methods:

Prospective longitudinal cohort study conducted in Brisbane, Australia, including adult women with newly diagnosed vulvar/vaginal cancer. The primary outcome was self-reported swelling of the legs, vulvar area, or pelvis/abdomen or a clinical diagnosis of lymphedema. Severity of associated symptoms and QOL (Functional Assessment of Cancer Therapy–General) were also reported. Assessments were conducted over 2 years.

Results:

All participants (vulvar: n = 20; vaginal: n = 2; mean [SD] age = 57 [12] years) received surgical treatment, and 8 (36%) also received adjuvant therapy. By 24 months postdiagnosis, only 2 (9%) women had no evidence of lymphedema; all others self-reported swelling (n = 10; 45%), had a clinical diagnosis (n = 1; 5%), or both (n = 9; 41%). Three or more symptoms of moderate or greater intensity were reported by 7 (44%) women at 2 years. The presence of lower limb symptoms (including mild intensity) was associated with reduced QOL (any symptom: QOL estimate = −13.29; 95% CI, −19.30 to −7.27; P < .001).

Limitations:

Small sample size limits interpretation of findings.

Conclusion:

These findings demonstrate that the majority of women receiving treatment of vulvar/vaginal cancer experience lymphedema and symptoms of swelling are associated with lower QOL. Monitoring of swelling via patient self-report may identify women at risk of low QOL outcomes after treatment of vulvar/vaginal cancer.

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