Development and evaluation of the Korean version of the Gynecologic Cancer Lymphedema Questionnaire in gynecologic cancer survivors

• Published in: Gynecologic oncology 2014-04, Vol.133 (1), p.111-116
• Main Authors: Lim, Myong Cheol, Lee, Jeong Seon, Joo, Jungnam, Park, KiByung, Yoo, Heon Jong, Seo, Sang-Soo, Kang, Sokbom, Chung, Seung Hyun, Park, Sang-Yoon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Area Under Curve; Cultural Characteristics; Endometrial Neoplasms - surgery; Female; Gynecologic cancer; Gynecologic cancer lymphedema questionnaire; Hematology, Oncology and Palliative Medicine; Humans; Language; Lymph Node Excision - adverse effects; Lymphedema; Lymphedema - diagnosis; Lymphedema - etiology; Middle Aged; Obstetrics and Gynecology; Ovarian Neoplasms - surgery; Reproducibility of Results; Sensitivity and Specificity; Surveys and Questionnaires; Uterine Cervical Neoplasms - surgery; Validation
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2014.01.040

Abstract Objective The purpose of this study was two-fold: first, to develop a Korean version of the Gynecologic Cancer Lymphedema Questionnaire (GCLQ-K) and evaluate its reliability and reproducibility and second, to examine the diagnostic efficacy of GCLQ-K in predicting lymphedema in gynecologic cancer survivors. Methods We designed a case–control study, and the GCLQ-K was completed by 33 gynecologic cancer survivors with lymphedema and 34 gynecologic cancer survivors without lymphedema. A follow-up GCLQ-K was completed 3 weeks after the baseline questionnaire. Results The GCLQ-K showed high reliability with a Cronbach's α of 0.83 and high reproducibility with an intraclass correlation of 0.96. Of the 7 symptom clusters, 6 identified patients with lymphedema with statistical significance; identification of lymphedema using the physical functioning and infection-related symptom clusters did not reach significance. The area under the receiver operating characteristic curve (AUC) to distinguish patients with and without lymphedema was 0.868 (95% confidence interval [CI], 0.779–0.956). Following the exclusion of the physical functioning and infection-related symptom clusters, which showed poor prediction value for lymphedema, the AUC of the GCLQ-K total score further improved to 0.922 (95% CI, 0.864–0.981). Conclusion The GCLQ-K was successfully developed with minimal modifications to adapt the original GCLQ to the Korean culture and showed high internal consistency and reproducibility. Moreover, gynecologic cancer survivors with and without lymphedema could be satisfactorily distinguished using the GCLQ-K. Thus, GCLQ-K was proven to be a reliable tool, capable of identifying lymphedema in Korean gynecological cancer survivors.