Analysis of Risk Factors of Lymphedema After Surgical Treatment in Cervical Cancer: A Case-Control Retrospective Study.

Objective: Cervical cancer is a common malignant tumor in the female reproductive system, surgery is the main radical treatment methods. Lymphedema, as a postoperative complication of cervical cancer, affects the prognosis of patients. Identifying the risk factors for lymphedema after surgery is of great clinical significance for reducing its incidence. This study aims to systematically analyze the related risk factors for lymphedema after cervical cancer surgery.

Methods: Clinical medical data of 701 cervical cancer patients at Meizhou People's Hospital from December 2018 to December 2023 were collected, including age, body mass index (BMI), hypertension, diabetes mellitus, induced abortion, menopause, clinical stage, number of dissected lymph nodes, lymph node metastasis, postoperative complications, postoperative chemotherapy, postoperative radiotherapy, postoperative living habits, and lymphedema. The relationship between lymphedema and clinical features in cervical cancer was analyzed.

Results: A total of 220 (31.4%) patients developed lymphedema and 481 (68.6%) did not. The cervical cancer patients with lymphedema had higher proportions of advanced age, hypertension, menopause, number of dissected lymph nodes≥30, postoperative radiotherapy, and sitting quietly> 1 hour every day than patients without lymphedema. Logistic regression analysis showed that advanced age (odds ratio (OR): 2.713, 95% confidence interval (CI): 1.560-4.717, p<0.001), menopause (OR: 1.954, 95% CI: 1.091-3.501, p=0.024), pelvic lymph nodes plus para-aortic lymph nodes plus inguinal lymph nodes were dissected (OR: 2.039, 95% CI: 1.297-3.207, p=0.002), number of dissected lymph nodes (≥30 vs <30, OR: 1.666, 95% CI: 1.105-2.514, p=0.015), postoperative radiotherapy (OR: 3.775, 95% CI: 2.348-6.069, p<0.001), and sitting quietly>1 hour every day (OR: 14.782, 95% CI: 7.926-27.567, p<0.001) were associated with lymphedema in cervical cancer.

Conclusion: Advanced age, menopause, pelvic lymph nodes plus para-aortic lymph nodes plus inguinal lymph nodes were dissected, number of dissected lymph nodes, postoperative complications, postoperative radiotherapy, and sitting quietly every day were independently associated with lymphedema in cervical cancer patients.