Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis
Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis
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DOI：
10.1016/s1470-2045(13)70076-7
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发表时间：
2013-05-01
期刊：
影响因子：
51.1
通讯作者：
Hayes, Sandi
中科院分区：
文献类型：
--
作者：
DiSipio, Tracey;Rye, Sheree;Hayes, Sandi
背景：在过去十年中，与乳腺癌相关的淋巴水肿发生率和危险因素相关的证据大量增加，质量也有所提高。我们评估了乳腺癌后单侧手臂淋巴水肿的发生率，并探讨了淋巴水肿危险因素的证据。方法：检索2000年1月1日至2012年6月30日期间发表的评估乳腺癌后臂淋巴水肿发生率、患病率或危险因素的研究文章，检索Academic Search Elite、护理与联合健康累积指数、Cochrane中央对照试验登记（临床试验）和Medline。我们提取发病率数据并计算相应的精确二项95% ci。我们使用随机效应模型来计算淋巴水肿发生率的汇总总体估计，并使用亚组分析来评估不同研究设计、研究来源国、诊断方法、诊断时间和腋窝手术程度的影响。我们评估了风险因素，并根据研究结果的一致性以及对研究结果有贡献的研究的质量和数量，将其整理为四个证据级别。72项研究符合淋巴水肿发生率评估的纳入标准，总估计值为16.6% （95% CI 13.6-20.2）。当限于前瞻性队列研究（30项研究）的数据时，我们的估计为21.4%（14.9- 29.8%）。膀臂淋巴水肿的发生率在乳腺癌诊断或手术后2年内似乎有所增加（24项研究，自诊断或手术后的时间为12至12年）
Background The body of evidence related to breast-cancer-related lymphoedema incidence and risk factors has substantially grown and improved in quality over the past decade. We assessed the incidence of unilateral arm lymphoedema after breast cancer and explored the evidence available for lymphoedema risk factors.Methods We searched Academic Search Elite, Cumulative Index to Nursing and Allied Health, Cochrane Central Register of Controlled Trials (clinical trials), and Medline for research articles that assessed the incidence or prevalence of, or risk factors for, arm lymphoedema after breast cancer, published between Jan 1, 2000, and June 30, 2012. We extracted incidence data and calculated corresponding exact binomial 95% CIs. We used random effects models to calculate a pooled overall estimate of lymphoedema incidence, with subgroup analyses to assess the effect of different study designs, countries of study origin, diagnostic methods, time since diagnosis, and extent of axillary surgery. We assessed risk factors and collated them into four levels of evidence, depending on consistency of findings and quality and quantity of studies contributing to findings.Findings 72 studies met the inclusion criteria for the assessment of lymphoedema incidence, giving a pooled estimate of 16.6% (95% CI 13.6-20.2). Our estimate was 21.4% (14.9-29.8) when restricted to data from prospective cohort studies (30 studies). The incidence of arm lymphoedema seemed to increase up to 2 years after diagnosis or surgery of breast cancer (24 studies with time since diagnosis or surgery of 12 to