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      Severe lymphoedema in gynaecological cancers: Impact of pneumatic compression on quality of life

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          Highlights

          • Lower limb lymphoedema adversely affects quality of life in gynaecological cancer patients.

          • Pneumatic compression devices facilitate home self-management of severe lymphoedema.

          • Significant improvement across all quality of life domains except sexual function was achieved.

          Abstract

          Objective

          Good survival rates from gynaecological cancers focus our attention on the quality of survivorship. Lymphoedema is a common complication that affects many aspects of quality of life (QOL). We undertook a prospective audit of QOL of patients with higher grade lymphoedema using home compression pneumatic devices. The aim of this study was to assess QOL in a mixed gynaecological cancer cohort before and after at least eight weeks of home compression treatment.

          Methods

          Thirteen patients with the most severely disabling lower limb lymphoedema based on routinely collected QOL scores or a history of hospital admissions with related infection were invited to participate. QOL was assessed using the EORTC QLQ-C30 Version 3.0 and a supplementary gynaecological cancer-specific lymphoedema questionnaire. Home compression therapy was introduced not sooner than 3 months after primary cancer treatment. All patients applied compression treatment for at least one hour per day. Descriptive statistics and Wilcoxon signed-rank test were applied. A p-value < 0.05 was considered statistically significant.

          Results

          All participants’ functional and symptom scores improved with compression therapy with the exception of sexual function.

          Conclusions

          Self-management with pneumatic compression devices at home is a useful adjunct in the management of severe lymphoedema. Our preliminary experience showed a substantial improvement in most QOL parameters. We cannot say if domiciliary treatment with this compression device would have broader application or a role in primary or secondary prevention of lymphoedema if introduced at an earlier stage.

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          Most cited references31

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          The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in Oncology

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            A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study.

            Sentinel-lymph-node mapping has been advocated as an alternative staging technique for endometrial cancer. The aim of this study was to measure the sensitivity and negative predictive value of sentinel-lymph-node mapping compared with the gold standard of complete lymphadenectomy in detecting metastatic disease for endometrial cancer.
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              A prospective analysis of 100 consecutive lymphovenous bypass cases for treatment of extremity lymphedema.

              The authors prospectively evaluated the efficacy of lymphovenous bypass in patients with lymphedema secondary to cancer treatment.
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                Author and article information

                Contributors
                Journal
                Gynecol Oncol Rep
                Gynecol Oncol Rep
                Gynecologic Oncology Reports
                Elsevier
                2352-5789
                07 December 2021
                February 2022
                07 December 2021
                : 39
                : 100902
                Affiliations
                [a ]Department of Gynaecology, St James’s Hospital, Dublin, Ireland
                [b ]School of Medicine, Trinity College Dublin, Dublin, Ireland
                [c ]Royal College of Surgeons, St Stephen’s Green, Dublin 2, Ireland
                Author notes
                [* ]Corresponding author at: Department of Gynaecology, St James’s Hospital, James Street, Dublin 8, Ireland. noreengleeson@ 123456dubgyn.org
                Article
                S2352-5789(21)00206-X 100902
                10.1016/j.gore.2021.100902
                8683719
                7aa34905-91b9-4028-aa01-7bddee1d0719
                © 2021 The Authors. Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 31 August 2021
                : 27 October 2021
                : 1 December 2021
                Categories
                Research Report

                gynaecological cancer,lymphoedema,quality of life
                gynaecological cancer, lymphoedema, quality of life

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