Skip to main content

Table 2 Studies reporting lymphedema prevalence or incidence

From: Prevalence and incidence of cancer related lymphedema in low and middle-income countries: a systematic review and meta-analysis

  Sample size Stage of Diagnosis Treatment received Measurement method Lymphedema definition Prevalence or Incidence Risk factors Quality of Article
Breast Cancer
 (Yılmaz and Coşkun 2019) [23], Turkey N = 64 Stage I-III Breast cancer surgery Self-reported and arm circumference > 1.5 cm difference and lymphedema severity was defined as mild (if the difference between the extremities measurement is less than 3 cm), moderate (3–5 cm) and severe (> 5 cm) 14/64 (21.9%) BMI and hand dominance High risk
 (Kibar, Dalyan Aras et al. 2017) [25], Turkey N = 287 Modified Radical Mastectomy or Lumpectomy; Chemotherapy and/or Radiotherapy Arm circumference ≥2 cm difference 119/287 (41.3%) Axillary radiotherapy and ALND Low risk
(Erdogan Iyigun, Selamoglu et al. 2015) [26], Turkey N = 37 Stages 0-II Surgery Bioimpedance, clinical diagnosis, arm circumference Impedance ratio > 10 8/37 (21.1%) Age, surgical procedure, tumor localization, systemic treatment, body mass index, and lymphedema High risk
(KİBar, Aras et al. 2015) [27], Turkey N = 190 Level III ALND subsequent to a modified radical mastectomy or lumpectomy together with chemotherapy or radiotherapy Arm circumference ≥2 cm difference 79/190 (41.5%) Age, BMI, chemotherapy High risk
(Ay, Kutun et al. 2014) [28], Turkey N = 5064 Stage I & II Mastectomy Arm circumference > 5 cm difference 1008/5064 (19.9%) Employment status, Age, BMI, post-operative chemotherapy treatment. Post axillary radiotherapy was not significant Low risk
(Ozcinar, Guler et al. 2012) [29], Turkey N = 221 Stage I, II, cT1, 2 N0 Surgery Arm circumference > 2 cm difference 16/221 (7.2%) Type of the surgical procedure done, RT to regional lymphatics, ALND and RT Administration to axilla Low risk
(Ozaslan and Kuru 2004) [30], Turkey N = 240 Stage I-III Surgery Arm circumference > 4 cm difference 68/240 (28%) Axillary radiotherapy; BMI Low risk
(Rebegea, Firescu et al. 2015) [21], Romania N = 305 Stages I-IV Surgery Arm circumference ≥2 cm difference 18/305 (5.9%) number of lymph nodes removed; stage of the disease; chemotherapy and hormonal therapy Low risk
(Borman, Yaman et al. 2018) [51], Brazil N = 135 Post breast cancer related with no advanced malignancy Volume measurement > 10% volume difference 125/135 (92.5%) High risk
(Vieira, Silva et al. 2018) [32], Brazil N = 16 ECOG scores of 0 to 1 Radiotherapy Arm circumference ≥200 mm difference 4/16 (25%) High risk
(Borman, Yaman et al. 2017) [51],
Brazil
N = 188 Subclinical, reversible, spontaneous irreversible, elephantiasis and stages I-III with mean time past after the surgery was 21.5 ± 27.5 months Surgery Self-reported arm swelling, arm circumferences A positive Stemmer’s sign 170/188 (90%) Lymphedema awareness High risk
(Godoy, Dias et al. 2014) [33], Brazil N = 1583 Surgery Self-reported arm LE Swelling of the arm 12/1583 (0.8%) suffered LE; 12/32 (37.5%) suffered LE due to axillary dissection High risk
(Paiva, Rodrigues et al. 2013) [34], Brazil N = 250 Surgery (more than 6 months) Perimetry ≥2 cm difference 112/250 (44.8%) ALND; SLNB; time after surgery Low risk
(do Nascimento, de Oliveira et al. 2012) [24], Brazil N = 707 Stages I-IV (presented with overweight, diabetic, hypertensive and shoulder dysfunction) Surgery Self-reported LE and perimetry Swelling of the arm 164/707 (23.2%) High risk
(de Godoy, Barufi et al. 2012) [35], Brazil N = 35 Breast cancer treatment Self-reported presence of chest swelling; Bioimpedance > 100 g difference 4/35 (11.42%) High risk
(Campanholi, Duprat et al. 2011) [20], Brazil N = 84 Surgery Arm and leg circumference; volume measurement; self-reported > 10% difference in volume; 0–10% = normal, 10.1–20% = mild, 20.1–40% = moderate, 40.1–80% = marked, > 80.1% = severe in the arms and classified in the leg as 0–6.5% = normal, 6.6–20% = mild, 20.1–40% = moderate and > 40.1% = severe 7/40 (17.5%) in the arm; 26/44 (59.1%) in the lower limb Local lymphadenecto-my including axillary, inguinal and ilioinguinal High risk
(Bergmann, Bourrus et al. 2011) [36], Brazil N = 220 Stages IIA, IIB, IIIA and IIIB Advanced Breast Cancer Treatment Self-report, volumetric measurement > 200 ml difference in volume 13/220 (6.6%) Obstruction of lymphatic drainage and clinical stage of the condition; Radiotherapy and chemotherapy and delay in accessing neo-adjuvant therapy Low risk
(Velloso, Barra et al. 2011) [37], Brazil N = 45 Surgery (21.3 months) Arm circumference > 10% difference 2/45 (4.4%) High risk
(Alem and Gurgel 2008) [38], Brazil N = 29 Post-surgery with mean time for breast cancer 86.1 ± 81.6 months. Breast Cancer Surgery Arm circumference ≥2 cm difference; a restriction of 20° or more in flexion and/or abduction in ROM. 23/29 (79.0%) High risk
(Paim, Lima et al. 2008) [5], Brazil N = 96 Surgery Arm circumference/ perimetry and Clinical diagnosis > 1 cm and any two of lymphedema symptoms of limb heaviness, swelling, tightness or firmness 17/96 (17%) and the prevalence with treatment; ALND 14/48 (29.2%) and SLNB 2/48 (4.2%) ALND; SLNB Low risk
(Batiston and Santiago 2005) [39], Brazil N = 160 Stage I - IV Radical surgery (68.8%) and conservative surgery (31.2%) Self-reported swelling 47/160 (29.2%) Time after surgery to physiotherapy rehabilitation High risk
(Elumelu-Kupoluyi, Adenipekun et al. 2013) [40], Nigeria N = 63 Stage II Radiotherapy Clinical diagnosis A positive stemmer’s sign 55/63 (78%) in the arm. High risk
(Khanna, Gupta et al. 2019) [41], India N = 98 Locally advanced (IIIB) and Early/palpable stage (I-IIIA) Breast carcinoma treatment; Mastectomy and Wide local incision Arm circumference ≥2 cm difference in limb between pre-op and post-op measurements 23/98 (23.5%) Drainage of seroma, type of treatment especially axillary radiotherapy and skin necrosis, chemotherapy Low risk
(Rastogi, Jain et al. 2018) [42], India N = 100 Stages IIA, IIB, IIIA, IIIB and IIIC Mastectomy, Radiotherapy and Axillary Lymph Node Dissection Arm circumference ≥2 cm difference 13/100 (13.0%) and 13/33 (39.4%) recorded by patients with BMI > 25 BMI; Number of lymph nodes removed; regional lymph node radiated High risk
(Gopal, Acharya et al. 2017) [43], India N = 199 Early and locally advanced stages Radiotherapy, Lymph Node dissection, Surgery and Chemotherapy Arm circumference > 5% difference 85/199 (42.7%) stage of cancer, BMI, receiving radiotherapy or chemotherapy, number of lymph nodes removed High risk
(Nandi, Mahata et al. 2014) [52],
India
N = 135 Grades I-IV Chemotherapy, Radiotherapy and Mastectomy Self-reported 9/135 (6.7%) High risk
(Raja, Damke et al. 2014) [44], India N = 30 Stage I and II Modified Radical Mastectomy with Axillary Clearance Self-reported Lymphedema grading system of mild, moderate and severe 17/30 (56.7%) High risk
(Deo, Ray et al. 2004) [45], India N = 299 Stage I, II & III Post Breast cancer treatment (Surgery & Radiotherapy) Arm Circumference > 3 cm 100/299 (33%) Axillary irradiation; comorbidities. Low risk
(Halder, Morewya et al. 2001) [46], Papua New Guinea (East Asia) N = 790 Stages I-IV Lumpectomy and Mastectomy Self-reported 3/790 (0.4%) High risk
(Haddad, Farzin et al. 2010) [54], Iran N = 355 Cases of no evidence of recurrence or metastases after surgery Surgery Arm circumference and self-reported swelling > 10% difference 63/355 (17.5%) Type of surgery, treatment with radiotherapy, and prescription of a supraclavicular field of radiation Low risk
(Honarvar, Sayar et al. 2016) [47], Iran N = 683 Modified radical mastectomy, conservative surgery, chemotherapy, radiotherapy and hormone therapy Arm circumference ≥2 cm difference and a positive stemmer’s sign 400/683 (58.6%) Type of surgery, treatment with radiotherapy, physical activity, modified radical mastectomy, BMI, hormone therapy, size of tumor, and number of excised or affected lymph nodes. Low risk
(Morcos, Al Ahmad et al. 2013) [48], Jordan N = 531 Surgery, chemotherapy and radiotherapy Arm circumference ≥2 cm difference 114/531 (21.4%) Surgery type received High risk
Vulvar Cancer
(de Melo Ferreira, de Figueiredo et al. 2012) [49], Brazil N = 50 Stage I-IV Vulvectomy Clinical diagnosis, observation and palpation by the clinician Severity and limb functions considered based on disabilities reported 28/56 (50%); 17/28 (60.7%) among cases and 3/28 (10.7%) among the control Severity and BMI High risk
(Eke, Alabi-Isama et al. 2010) [53], Nigeria N = 11 Stages IB-IV Vulvar carcinoma surgery Self-reported LLE 1/11 (9.1%) High risk
Cervical Cancer
(Marin, Pleşca et al. 2014) [50], Romania N = 324 Lymphadenohysterocolpectomy; Radical hysterectomy Self-reported 37/324 (11.4%);
lower limb lymphedema (13.5% III vs 11.5% II)
High risk
(Elumelu-Kupoluyi, Adenipekun et al. 2013) [40], Nigeria N = 63 Stage II Radiotherapy Clinical diagnosis A positive stemmer’s sign 8/63 (13%) in the leg High risk
(Dem, Kasse et al. 2001), Senegal [22] N = 86 Stages I-IV Cervical cancer treatment Self-reported 6/86 (6.98%) in the leg High risk