ASPO Abstracts
Lower-extremity lymphedema, physical functioning, and activities of daily living in the WHI LILAC survivorship cohort
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2021
Abstract Body:
Purpose of the study: To examine lower-extremity lymphedema (LEL) among older female cancer survivors with
colorectal, endometrial, or ovarian cancer, and to determine the association of LEL with physical functioning, and
activities of daily living (ADLs).
Methods: Data from the Women's Health Initiative (WHI) Life and Longevity after Cancer (LILAC) Study were
used. Validated surveys assessed LEL, physical functioning, and ADLs. Linear regression and logistic regression
were used to examine the association of LEL, physical functioning scores (PFS), and whether needing help with
ADLs. We also examined whether cancer type and age groups (65-79 years vs. ≥80 years) could modify these
associations.
Results: Female colorectal, endometrial, and ovarian cancer survivors from the LILAC study were included in the
analysis (n=900). Among these women, 292 (32.4%) reported LEL, with the highest prevalence of LEL in ovarian
cancer survivors (36.5%), followed by endometrial (32.5%) and colorectal cancer survivors (31.4%). Compared to
women without LEL, women with LEL had 16.8±1.7 lower PFS (P<0.0001). Similarly, women with LEL had a
higher odds of needing help with ADLs (OR=2.45, 95% CI: 1.64-3.67). The association of LEL was higher on
physical functioning and ADLs among colorectal cancer survivors, although the interaction between LEL and
cancer type was not significant. Overall, the difference in PFS between women with LEL vs. women without LEL
was greater among those ≥80 years vs. those aged 65-79 years. However, among colorectal cancer survivors, the
association with PFS was greater among women aged 65-79 years vs. women ≥80 years (Page*LEL*cancer
type=0.03).
Conclusions: At least a third of older female colorectal, endometrial, and ovarian cancer survivors experienced
LEL. LEL was associated with lower physical functioning and greater odds of needing help with ADLs. Our
findings suggest that healthcare providers should regularly assess LEL among cancer survivors and provide
effective interventions to reduce LEL symptoms and improve physical functioning for older cancer survivors.
Keywords: lower-extremity lymphedema; cancer survivorship; physical functioning