The Delphi method was used to construct a multi-dimensional risk factor assessment table for postoperative lower extremity lymphedema after gynecological malignant tumor surgery, providing a reference basis for clinical medical staff to identify high-risk groups for lower extremity lymphedema after gynecological malignant tumor surgery. Through literature review and discussions among the research group members, the risk factors for lower extremity lymphedema after gynecological malignant tumor surgery were initially determined. Eight experts from eight provinces and cities across the country were selected for three rounds of Delphi expert inquiries. The obtained data were summarized and analyzed, and finally, a risk factor assessment table for lower extremity lymphedema after gynecological malignant tumor surgery was formed. The positive coefficients of the three rounds of expert inquiries were 95%, 100%, and 95% respectively; the authoritative coefficients were 0.92, 0.92, and 0.93 respectively; the Kendall's coefficient of agreement among experts was 0.497, 0.415, and 0.447 (all P<0.001). The final formed risk factor assessment table for lower extremity lymphedema after gynecological malignant tumor surgery includes 5 primary indicators and 23 secondary indicators. The multi-dimensional risk factor assessment table for lower extremity lymphedema after gynecological malignant tumor surgery constructed based on the Delphi method is relatively scientific and reasonable, and can provide a reference basis for the prevention and assessment of lower extremity lymphedema after gynecological malignant tumor surgery.

Fengxiang Du, Yajuan Sun, Yaxin Xu, Juan Xie. Development of a Multidimensional Assessment Form for Risk Factors of Postoperative Lower Limb Lymphedema in Gynecological Malignancies: A Delphi-Based Study. Academic Journal of Medicine & Health Sciences (2026), Vol. 7, Issue 1: 18-24. https://doi.org/10.25236/AJMHS.2026.070103.

[1] Brey F, Laversan M, Song H et al. Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality for 36 Cancers in 185 Countries [J]. Journal of Clinical Oncology, 2024, 74(3): 229-263.

[2] Desoles K, Aviki E, Letao MM Jr. Lower limb lymphedema in patients with gynecological malignant tumors [J]. International Journal of Gynecologic Cancer: Official Journal of the International Gynecologic Cancer Society, 2020, 30(2): 252-260.

[3] Zhang Yanmei, Chen Ying, Yan Mingfang. Risk factors for lower limb lymphedema after cervical cancer surgery and its impact on quality of life [J]. Chinese and Foreign Medical Research, 2021, 19(30): 14-17. DOI: 10.14033/j.cnki.cfmr.2021.30.004.

[4] Jiang Qinghua, Chen Yuemei, He Ting. A qualitative study on the illness experience of patients with lower limb lymphedema after cervical cancer treatment [J]. Shanghai Nursing, 2021, 21(08): 25-28.

[5] Kong Weimin, Zhang He. Expert consensus on lower limb lymphedema after gynecological tumor treatment [J]. Chinese Journal of Clinical Physicians, 2021, 49(02):149-155.

[6] Barry M M, Battel-Kiek B, Dempsey C. European Core Competencies Framework for Health Promotion [J]. Health Education and Behavior, 2012, 39(6):648-662.

[7] Ye Weijuan, Lyu Qingyuan, Gan Yali, et al. Construction and Validation of a Risk Prediction Model for Limb Lymphoedema After Surgery for Gynecological Malignant Tumors [J]. Journal of Nursing Education, 2023, 38(21):1927-1931.

[8] Liu Yun, Zheng Zhijian, Huang Yuanfang. Study on risk factors for perineal and lower limb lymphedema after radiotherapy for cervical cancer [J]. Chinese Journal of Clinical Oncology and Rehabilitation, 2021, 28(06):710-714.

[9] Sudduth CL, Greene AK. Current Overview of Obesity-Induced Lymphedema. Adv Wound Care (New Rochelle). 2022 Jul;11(7):392-398. doi: 10.1089/wound.2020.1337. Epub 2021 Jan 27. PMID: 33493081.

[10] Xu Linna. Construction and Evaluation of a Warning Model for Lower Extremity Lymphoedema in Patients with Gynaecological Malignant Tumours After Surgery [J]. Modern Medicine, 2022, 50(02):201-206.

[11] Rebegea L F, Stoleriu G, Manolache N, et al. Associated risk factors for lower limb lymphedema after treatment for cervical and endometrial cancer [J]. Experimental and Therapeutic Medicine, 2020, 20(6):181.

[12] Lyu Yongli, Geng Li, Wan Yinglu, et al. Construction and validation of a risk prediction model for lower limb lymphedema in patients with endometrial cancer after surgery [J]. Chinese Journal of Nursing, 2021, 56(08): 117.

[13] Biglia N, Librino A, Ottino M C, et al. Lower limb lymphedema and neurological complications after lymphadenectomy for gynecological cancer[J]. Int J Gynecol Cancer, 2015,25(3):521-525.

[14] Wang Jianli, Yao Desheng. Research progress on the pathogenesis of lower limb lymphedema after lymph node dissection for gynecological malignant tumors[J]. Advances in Modern Obstetrics and Gynecology, 2019,28(11):864-868.

[15] Jiang Xingge, Li Xia, Yang Yang, et al. Analysis of risk factors for lower limb lymphedema after surgery in patients with gynecological malignant tumors [J]. Nursing Research, 2024, 38(12):2221-2224.

[16] Jiang Xingge. Construction and validation of a risk prediction model for lower limb lymphedema after surgery in patients with gynecological malignant tumors [D]. Shanxi: Shanxi Medical University, 2023.  

[17] Du Bai-ru, Dong Jun, Han Shi-chao, et al. Observation on the Effect of Resistance Training on Lower Limb Lymphoedema After Pelvic Lymph Node Dissection for Cervical Cancer [J]. Chinese Journal of Health Medicine, 2023, 25(4): 403-406. DOI:10.3969/j.issn.1674-3245.2023.04.010.

[18] Zhang Mengxing, Hou Shengqun, Zhang Xiaoju, et al. Evidence Summary on Lymphoedema Risk and Preventive Interventions in Breast Cancer and Gynaecological Cancer Patients [J]. Journal of Nursing, 2020, 35(20):18-22. DOI:10.3870/j.issn.1001-4152.2020.20.018.

[19] Gracia M, Alonso-Espías M, Zapardiel I. Impact of sentinel node use in lymphedema formation among gynecologic cancer patients [J] Curr Opin Oncol, 2024,36(5):406-411.

[20] Li Lili, Chen Guowei, Wei Lvwei. Correlation between NLR, PLR, SII and lower limb lymphedema after laparoscopic cervical cancer surgery [J]. Practical Gynecological Endocrinology Electronic Journal, 2023, 10(34):11-15.

[21] Liu Gaoming, Hu Jin, Liu Yuanyuan, et al. Case-control study on factors influencing lower limb lymphedema after cervical cancer surgery [J]. Journal of Nursing, 2022, 37(01):32-35.