Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Lymphedema and self-reported swelling among Danish survivors of prostate cancer - prevalence, clinical associations and functional implications.
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Levinsen Anne Katrine Graudal, Ammitzbøll Gunn, Kjaer Trille Kristina, Borre Michael, Larsen Signe Benzon, Dalton Susanne Oksbjerg
Аннотация
PURPOSE: To study lymphedema prevalence, risk factors, and the effect on physical and emotional functioning among survivors of prostate cancer.
METHODS: Using the Danish SEQUEL cohort, we identified 44,101 survivors diagnosed with prostate cancer (2010-2021). Lymphedema was assessed using hospital-based treatment records of lymphedema from the National Patient Registry and for a sub-cohort of 9619 men as self-reported swelling in the leg(s) and other areas using EORTC items. Physical and emotional functioning were assessed using the EORTC QLQ-C30. Cox models and logistic regression analyses examined the associations between clinical, lifestyle factors and lymphedema treatment/swelling, and the relationship between swelling and physical/emotional functioning.
RESULTS: Among survivors, 2% received lymphedema treatment and 8% reported swelling. The risk of receiving lymphedema treatment was higher for survivors with metastatic vs. low-risk disease (hazard ratio (HR) 5.38, 95% confidence interval (CI) 4.50-6.44), radical prostatectomy vs. active surveillance (HR 4.80, 95% CI 3.37-6.82), and radiation or endocrine therapy vs. watchful waiting (HR 3.44, 95% CI 1.92-6.15; HR 9.01, 95% CI 5.43-14.96, respectively). Survivors with obesity vs. healthy weight had a higher risk of self-reported swelling (odds ratio (OR) 3.52, 95% CI 2.87-4.34). Swelling was associated with impaired physical (OR 3.75, 95% CI 3.20-4.41) and emotional function (OR 4.41, 95% CI 3.44-5.62).
CONCLUSION: Radical prostatectomy, radiation, endocrine therapy, metastatic disease, and obesity increase the risk of lymphedema treatment. Self-reported swelling was associated with impaired physical and emotional functioning, underscoring the need for targeted monitoring and lifestyle interventions.
METHODS: Using the Danish SEQUEL cohort, we identified 44,101 survivors diagnosed with prostate cancer (2010-2021). Lymphedema was assessed using hospital-based treatment records of lymphedema from the National Patient Registry and for a sub-cohort of 9619 men as self-reported swelling in the leg(s) and other areas using EORTC items. Physical and emotional functioning were assessed using the EORTC QLQ-C30. Cox models and logistic regression analyses examined the associations between clinical, lifestyle factors and lymphedema treatment/swelling, and the relationship between swelling and physical/emotional functioning.
RESULTS: Among survivors, 2% received lymphedema treatment and 8% reported swelling. The risk of receiving lymphedema treatment was higher for survivors with metastatic vs. low-risk disease (hazard ratio (HR) 5.38, 95% confidence interval (CI) 4.50-6.44), radical prostatectomy vs. active surveillance (HR 4.80, 95% CI 3.37-6.82), and radiation or endocrine therapy vs. watchful waiting (HR 3.44, 95% CI 1.92-6.15; HR 9.01, 95% CI 5.43-14.96, respectively). Survivors with obesity vs. healthy weight had a higher risk of self-reported swelling (odds ratio (OR) 3.52, 95% CI 2.87-4.34). Swelling was associated with impaired physical (OR 3.75, 95% CI 3.20-4.41) and emotional function (OR 4.41, 95% CI 3.44-5.62).
CONCLUSION: Radical prostatectomy, radiation, endocrine therapy, metastatic disease, and obesity increase the risk of lymphedema treatment. Self-reported swelling was associated with impaired physical and emotional functioning, underscoring the need for targeted monitoring and lifestyle interventions.