Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

The relationship between lower-limb lymphoedema and anxiety, depression, quality of life and overall survival post-gynaecological cancer (#380)

Melanie L Plinsinga 1 , Monika Janda 2 , Hildegard Reul-Hirche 1 , Dimitrios Vagenas 3 , Andreas Obermair 4 , Kira Bloomquist 1 , Sandi Hayes 5
  1. School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
  2. Centre for Health Services Research, Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
  3. School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia
  4. Queensland Centre for Gynaecological Cancer Research, The University of Queensland, St Lucia, Queensland, Australia
  5. Cancer Council Queensland, Fortitude Valley, Queensland, Australia

Aims: To (1) establish cumulative burden of lower-limb lymphoedema, and (2) determine the relationship between lower-limb lymphoedema and anxiety, depression, quality of life and overall survival following gynaecological cancer.

Methods: Data from the LEG study, which is a prospective, longitudinal, cohort study including 408 women with gynaecological cancer, contributed to analyses. Outcomes of interest were assessed at baseline (pre-definitive diagnosis of gynaecological cancer) and at 6 weeks to 3 months, 6 months to 12 months and 15 to 24 months post-surgery. Linear regression analyses were undertaken to assess associations between cumulative burden of lower-limb lymphoedema (any evidence of lower-limb swelling within the first 24 months post-surgery) and anxiety and depression (measured via the Hospital Anxiety and Depression Scale) and quality of life (measured via the Functional Assessment of Cancer Therapy-General) assessed at 24 months post-surgery. Logistic regression was used to assess the relationship between cumulative burden of lower-limb lymphoedema and overall survival at 5-years follow up. Results were described using means (SD) and n (%), and p<0.05 was considered statistically significant.

Results: The cumulative incidence of lymphoedema was 37% and 45% by 24 months post-diagnosis, when measured objectively and via self-report, respectively. Those with self-reported lymphoedema reported higher anxiety and depression scores and lower quality of life when compared with those who did not report leg swelling (differences were clinically relevant; p<0.05), but these relationships were not seen for objectively-measured lymphoedema. Overall survival at 5-year follow up did not differ between groups for self-reported lymphoedema (those with evidence of swelling: 30% deaths; no evidence of swelling: 36% deaths; p=0.34), but when lower-limb lymphoedema was objectively measured, those with lymphoedema had a 1.6 higher hazard of death compared to those without (HR: 1.6, 95%CI: 0.80 – 3.39).  

Conclusions: These findings demonstrate the impact of swelling on health outcomes and potentially survival.