Aims: To describe the prevalence of lower-limb symptoms (LLS) pre- through to 2-years post-surgery for newly diagnosed gynaecological cancers, and to assess the relationship between the presence of LLS and lymphoedema, quality of life, anxiety and depression.

Methods: Lymphoedema (measured via bioimpedance spectrometry), 14 LLS (5-point Likert; none to extreme severity), quality-of-life (Functional Assessment of Cancer Therapy -General), anxiety and depression (Hospital Anxiety and Depression Scale) were prospectively collected pre-surgery, and at 6-, 12- and 24-months post-surgery in 408 women with gynaecological cancer. Point prevalence was calculated for each LLS at all time-points. Generalised estimating equation modelling was used to assess the relationship between LLS and lymphoedema, quality of life, anxiety and depression (adjusted for age, body mass index, stage, and cancer type).

Results: Women were on average 59 (SD: 11) years at diagnosis, 58% were diagnosed with stage I disease, and 58%, 28%, 9% and 5% were diagnosed with endometrial, ovarian, cervical, and vulvar/vaginal cancer, respectively. Women reported on average 3.7 (SD: 3.5) LLS at baseline. Prevalence of any given symptom among all gynaecological cancer types ranged between 11-49%, 11-52%, 9-57%, and 11-59% at baseline, 6-, 12- and 24-months post-surgery, respectively, with the most prevalent symptoms being pain, stiffness, and aching (prevalence > 40% across all time-points). Pins and needles, and numbness were most prevalent in women with ovarian cancer (P < 0.05); none of the other symptoms differed between cancer type. Compared with women without LLS, those with LLS reported poorer quality of life (beta: -9.5), higher anxiety (beta: 1.7) and depression (beta: 1.8) (all differences were clinically relevant; P < 0.001) and had higher odds of having lymphoedema (odds ratio: 1.8; 95%CI: 1.0–3.2).

Conclusions: Lower limb symptoms are prevalent up to 2-years post-surgery for gynaecological cancers and are associated with higher treatment-related morbidity and poorer health outcomes.