ArticleFrontiers in oncology2026
Effect of BMI-stratified management based on the meridian-lymph axis theory on lower extremity lymphedema after gynecological cancer surgery: a randomized controlled trial.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07374835 (BMI Stratified Management Based on Meridian-Lymph Axis Theory for Lower Extremity Lymphedema in Patients After Gynecologic Cancer Surgery), which is not on this map. Not yet cited in PubMed.
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BMI Stratified Management Based on Meridian-Lymph Axis Theory for Lower Extremity Lymphedema in Patients After Gynecologic Cancer Surgery
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Abstract
Background: Lower-extremity lymphedema (LEL) is a chronic complication after gynecological cancer surgery. Obesity may aggravate lymphatic dysfunction and reduce the effectiveness of standard physical management. We evaluated a BMI-stratified integrated intervention informed by a meridian-lymph conceptual framework. Methods: A total of 60 patients with gynecological cancer-related LEL were randomly assigned in a 1:1 ratio to an intervention group (n=30) or a control group (n=30). The intervention group received BMI-stratified meridian massage and dietary and health guidance for 6 months, whereas the control group received compression stockings, health education, and aerobic exercise. Patients were divided into three subgroups by BMI: <24 kg/m², 24-27.9 kg/m², and ≥28 kg/m². The primary outcome was change in affected-limb volume, and quality of life was assessed using LYMQOL. Outcome assessors were blinded to group allocation. Results: At 6 months, affected-limb volume decreased by 32.1 ± 6.2% in the intervention group and 14.3 ± 5.8% in the control group (P<0.01). LYMQOL scores improved by 15.2 ± 3.1 and 6.8 ± 2.9 points, respectively (P<0.01). Exploratory subgroup analysis suggested a greater volume reduction among participants with BMI ≥28 kg/m² than among those with BMI 24-27.9 kg/m² (P = 0.02). Three participants in the intervention group developed transient skin redness, and no serious adverse events were reported. Conclusion: In patients with LEL after gynecological cancer surgery, the BMI-stratified integrated intervention was associated with greater improvement in limb volume and quality of life than conventional care over 6 months. Clinical trial registration: ClinicalTrials.gov, identifier NCT07374835.
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