Does the prophylactic use of compression garments reduce the risk of lower limb lymphedema after pelvic and/or inguinal lymphadenectomy for gynecological cancer? A systematic review.

Authors

Stefano Gentileschi, Giorgia Garganese, Simona Maria Fragomeni, Luca Tagliaferri, Anna Fagotti, Anna Amelia Caretto

Published in

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society. Volume 36. Issue 9. Pages 104840. Jun 29, 2026. Epub Jun 29, 2026.

Abstract

Our goal was to assess whether prophylactic compression garments reduce lower-limb lymphedema after pelvic/inguinal lymphadenectomy for gynecologic malignancies.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses.-based systematic review. Eligible studies included primary interventional studies evaluating prophylactic lower-limb compression after pelvic and/or inguinal lymphadenectomy for gynecological malignancies; systematic/rapid reviews were considered for contextual background and reference checking; studies focused on treatment of established lymphedema or non-relevant populations/outcomes were excluded. The Population, Intervention, Comparison, Outcome question was: in women undergoing pelvic and/or inguinal lymphadenectomy for gynecological malignancy (P), does prophylactic use of compression garments (I), compared with no compression garments or non-compressive preventive strategies (C), reduce the incidence of lower-limb lymphedema (O)? PubMed, Scopus, Cochrane, LILACS, and SciELO were searched from inception through March8 2026, using Medical Subject Headings and free-text terms related to compression garments, lymphedema prevention, pelvic or inguinal lymphadenectomy, gynecological cancer, and lower-limb lymphedema.
A total of 536 full-text reports were assessed; 6 gynecological oncology randomized controlled trials met the Population, Intervention, Comparison, Outcome criteria; one additional mixed-population randomized controlled trial was treated as indirect evidence. Two systematic/rapid reviews were used for contextual background/reference checking; multimodal prevention studies were discussed as evidence for multimodal pathways because compression effects could not be isolated. Randomized controlled trials were heterogeneous: small trials using class I to II stockings did not demonstrate a significant reduction in lower-limb lymphedema, although they suggested a potential benefit. One randomized controlled trial (n = 64) showed a reduction in lymphedema incidence (3.4% vs 38.7%) with class II (23-32 mmHg) stockings worn for 12 months, alongside education and physical activity.
Prophylactic compression-particularly early, prolonged class II stockings within structured rehabilitation-was associated with lower lymphedema incidence in some studies; evidence remains limited by small, heterogeneous trials, no meta-analysis, and multimodal interventions where compression effects cannot be isolated.

PMID:
42526142
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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