Incidence, prevalence, and factors associated with lymphedema after treatment for cervical cancer: a systematic review.

BACKGROUND: Lower limb lymphedema is a frequent and debilitating complication after cervical cancer treatment. OBJECTIVE: To evaluate the incidence and prevalence of lymphedema after treatment for cervical cancer and evaluate the factors associated with this outcome. METHODS: The study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Eligible studies were identified through the databases Medline (via PubMed), LILACS, Scopus, and Web of Science. For the search, descriptors, keywords, and synonyms were used for cervical cancer, lymphedema, and outcomes of interest (incidence, prevalence, frequency, occurrence, morbidity, risk factors, and prognosis). Observational studies were included that were published in English, Portuguese, or Spanish, between January 1, 2013 and December 31, 2019, with frequency data and associated factors for lymphedema after cervical cancer treatment. Studies that evaluated the presence of lymphedema less than 6 months after surgery or radiotherapy and those in which frequency data were not stratified by tumor topography, were excluded. RESULTS: Twenty-three studies were included. The incidence of lymphedema varied between 0% and 69%. Different designs and methods were employed for lymphedema assessment. The main factors associated with lymphedema included extension of lymphadenectomy, number of lymph nodes removed, removal of circumflex iliac lymph nodes, and adjuvant radiotherapy. Other factors associated with lymphedema included cellulitis, lymphocyst formation, increased age, invasive lymph node staging, higher body mass index, and insufficient physical activity. CONCLUSIONS: The frequency of lymphedema after treatment for cervical cancer is variable. The different designs and methodology to measure this complication make it difficult to draw definitive conclusions about its prevalence. The method used for lymphedema assessment is not standardized.

Translation and Cross-Cultural Adaptation of the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema into Portuguese Language.

OBJECTIVE: The objective of the study is to describe the process of translation and cross-cultural adaptation of the Lymphoedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) into (Brazilian) Portuguese. METHODS: The process was comprised of five steps - translation, back translation, revision by an expert panel, pretest, and final translation. The first translation was performed by two professionals of the healthcare area, and the back translation was performed by two translators. An expert panel assessed the questions for semantics and idiomatic, cultural, and conceptual equivalence. The pretest was conducted on 10 patients with lymphedema. RESULTS: Small differences were identified between the translated and back-translated versions, which were revised by the expert panel. The patients included in the pretest found 10 questions difficult to understand; these questions were reassessed by the same expert panel. CONCLUSION: The results of the translation and cross-cultural adaptation of the Lymph-ICF-LL resulted in a Brazilian Portuguese version, which still requires validation with various samples of the local population.

Translation and Cross-Cultural Adaptation of the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema into Portuguese Language / Tradução e adaptação transcultural do Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema para o português brasileiro

Objective The objective of the study is to describe the process of translation and cross-cultural adaptation of the Lymphoedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) into (Brazilian) Portuguese. Methods The process was comprised of five steps - translation, back translation, revision by an expert panel, pretest, and final translation. The first translation was performed by two professionals of the healthcare area, and the back translation was performed by two translators. An expert panel assessed the questions for semantics and idiomatic, cultural, and conceptual equivalence. The pretest was conducted on 10 patients with lymphedema. Results Small differences were identified between the translated and back-translated versions, which were revised by the expert panel. The patients included in the pretest found 10 questions difficult to understand; these questions were reassessed by the same expert panel. Conclusion The results of the translation and cross-cultural adaptation of the Lymph- ICF-LL resulted in a Brazilian Portuguese version, which still requires validation with various samples of the local population.

Objetivo Descrever o processo de tradução e adaptação transcultural para o português (Brasil) do instrumento Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL). Métodos O processo foi realizado em cinco fases: tradução, retro-tradução, revisão por um comitê de especialistas, pré-teste e tradução final. A tradução inicial foi realizada por dois profissionais e a retro-tradução por dois tradutores. Um comitê de especialistas avaliou a semântica, equivalências idiomática, cultural, e conceitual das questões. Foi realizado um pré-teste em 10 pacientes com linfedema. Resultados Durante o processo de tradução e retro-tradução, foram identificadas pequenas diferenças que foram revisadas pelo comitê. Os pacientes incluídos no préteste identificaram 10 questões como sendo de difícil compreensão, as quais foram reavaliadas pelo mesmo comitê de especialistas. Conclusão Os resultados obtidos após o processo de tradução e adaptação transcultural permitiram a criação de uminstrumento que necessita ser validado emdiferentes populações brasileiras.