Leung, E.Y., Tirlapur, S.A., & Meads, C. (2015). The management of secondary lower limb lymphoedema in cancer patients: A systematic review. Palliative Medicine, 29, 112–119. 

STUDY PURPOSE: To evaluate the evidence for the treatment of lower limb lymphedema in patients with cancer

• DATABASES USED: MEDLINE, EMBASE, LILACS, Science Citation Index, Cochrane CENTRAL, International Society of Lymphology, Australian Lymphoedema Association congress proceedings, and SIGLE
• KEYWORDS: Secondary lymphedema and therapy with medical subject headings (full terms available in article)
• INCLUSION CRITERIA: Randomized, controlled trials and comparative observational studies including at least 50 participants with cancer
• EXCLUSION CRITERIA: Studies with no description of treatment effects

• FINAL NUMBER STUDIES INCLUDED = 7
• TOTAL PATIENTS INCLUDED IN REVIEW = 778
• SAMPLE RANGE ACROSS STUDIES = 18–260 patients
• KEY SAMPLE CHARACTERISTICS: Mixed etiologies of lymphedema and various tumor types

PHASE OF CARE: Late effects and survivorship

The treatments included in this study were compression stockings, coumarin, pneumatic compression devices, microsurgery, manual lymphatic drainage, and an herbal remedy combining coumarin ginkgo and melitoto. There was a high risk of bias among the studies. Various methods of measuring limb volume were used. All studies reported favorable outcomes with a reduction of limb excess volume from 6.8% to 20%. The largest effect was reported with complete decongestive therapy. Some studies included patients with lymphedema etiologies other than cancer. Only one study using each type of intervention was found.

The effectiveness of various treatments for lower limb lymphedema are unclear because of the very limited evidence in this area.

• Low-quality studies
• Very few studies found

There is very little evidence regarding the efficacy of various interventions for lower limb lymphedema in patients with cancer. Lymphedema can be disabling, and effective interventions have not been identified. This is an area in which additional, well-designed research is needed.