Self-measured leg circumference for the detection of lymphedema among men with prostate cancer: a reliability study

BACKGROUND AND PURPOSE: Early lymphedema detection is crucial to timely treatment, and home-based monitoring holds promise for early detection of leg lymphedema among at-risk cancer survivors. We developed a self-measurement protocol for home-based leg circumference measurements and tested its reliability in men with prostate cancer at risk of lymphedema.

PATIENTS/MATERIAL AND METHODS: This cross-sectional study recruited men with prostate cancer from the Department of Urology, Copenhagen University Hospital, Denmark. Circumference measurements were taken at four points on both legs, from which leg volume was calculated. Intrarater reliability was assessed by comparing self-measurements taken at home and in the hospital. Interrater reliability was evaluated by comparing hospital self-measurements to those of a blinded physiotherapist. Statistical power required 13 participants for the detection of a good (>0.8) intraclass correlation coefficient (ICC).

RESULTS: Forty-three men were included (median age 69 [63-76] years). Intrarater reliability (n = 39) was good to excellent for six out of eight measurement points (ICC ≥ 0.79, p < 0.01) and moderate for two (ICC ≥ 0.55, p < 0.01). Intrarater reliability for leg volume was excellent (ICC ≥ 0.96, p < 0.01). Similarly, interrater reliability (n = 23) was excellent for all measurement points and leg volumes (ICC ≥ 0.91, p < 0.01). Forty-one of 43 participants performed the measurements independently, found them easy to do, and were willing to conduct self-measurements if recommended by their doctor.

INTERPRETATION: Self-measured leg circumference among men with prostate cancer is highly reliable and acceptable. This low-cost approach for home-based monitoring for lymphedema offers potential for early detection and timely management of the condition.