Clinical Analysis of the Extremity of Lymphedema

Kim, Eun Sook; Kim, Dong Ik; Moon, Ji Young; Huh, Se Ho; Hwang, Ji Hye; Lee, Byung Boong

Abstract

PURPOSE: Given the increased frequency of operative therapy and radiation therapy on breast cancers and uterine cancers, there is very little information on lymphedema associated with these treatments in Korea. Thus, the authors conducted this study to describe and analyze the data which they had obtained from the patients. METHOD: A retrospective study was undertaken on 840 patients who registered to the Lymphedema Clinic of Samsung Seoul Hospital throughout the period of February 1995 to August 2001. RESULT: Out of 840 patients, 205 patients (24%) were confirmed as having primary lymphedema, while 635 patients (76%) had secondary lymphedema. The ratio of male to female for primary lymphedema was 1:1.8 (Male:Female), while secondary lymphedema demonstrated to be 1:21 (Male:Female), demonstrating a female preponderance. Secondary lymphedema mostly developed after undergoing treatment for uterine cancer (341 patients, 53.7%) and Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. breast cancer (226 patients, 35.5%). The lesions of occurrence for both primary and secondary lymphedema were mainly in the lower extremities than the upper extremities. In regards to the degree of clinical edema, a large number of the patients, that is 633 patients (76%) had progressed to Stage II-III. Among the patients who developed edema after undergoing treatment for cancers, only 43 patients (7%) were provided information on the possibility of developing lymphedema, while the majority of the patients had no knowledge about this possibility. When the patients' subjective experiences were investigated on the degree of the edema, there was no significant increase in pain despite an increase in the degree of the edema (P<0.05), nevertheless, a significant increase was found in cosmetic problems (P>0.05).
CONCLUSION
As a general rule, complete recovery from chronic lymphedema is not expected. However, early detection of lymphedema and timely appropriate treatment as well as aggressive patient education on lymphedema and its related complications can prevent its progression.