Risk factors for breast cancer-related upper extremity lymphedema:a meta-analysis / 中华放射肿瘤学杂志

ABSTRACT

Objective To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations.Methods PubMed,Ovid,EMbase,and the Cochrane Library were searched to identify clinical trials published up to December 2012.The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2;the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95％ confidence intervals (CI).Results Twenty-two studies involving 10106 patients were included in the meta-analysis.The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR =2.72,95％ CI=1.06-6.99,P=0.038),hypertension (OR=1.84,95％ CI=1.38-2.44,P=0.000),body mass index (OR =1.68,95％ CI=1.22-2.32,P =0.001),and radiotherapy (OR =1.65,95％ CI =1.20-2.25,P =0.002),while no significant associations were found for such factors as chemotherapy,age,number of positive lymph nodes,and number of dissected lymph nodes.Conclusions The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment,and axillary lymph node dissection,hypertension,body mass index,and radiotherapy are the main risk factors for lymphedema after breast cancer treatment.