{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:50:49Z","timestamp":1791337849612,"version":"4.3.1"},"reference-count":49,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the pooled prevalence of lymphedema among adults with mucosal head and neck cancer treated with radiation therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, Scopus, and Cochrane Library.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>\n                      A comprehensive literature search of PubMed, Embase, Scopus, and Cochrane Library (2000\u20132025) identified cohort, case series, cross\u2010sectional, and clinical trial studies reporting lymphedema after radiotherapy for head and neck cancer. Logit\u2010transformed lymphedema prevalence was pooled using a DerSimonian\u2010Laird random\u2010effects model with Hartung\u2010Knapp\u2010Sidik\u2010Jonkman variance correction; statistical heterogeneity was evaluated using I\n                      <jats:sup>2<\/jats:sup>\n                      . This review was not prospectively registered.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 26 studies (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093133 patients) met inclusion criteria. The pooled prevalence of lymphedema was 49% (95% CI, 36%\u201362%), with considerable heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200994%). Subgroup analyses yielded a pooled prevalence of 37% (12%\u201371%) for external and 45% (31%\u201360%) for internal lymphedema. Among studies reporting severity\u2010graded data, the pooled prevalence of clinically significant (grade \u2265\u20092) lymphedema was 32% (14%\u201359%). Lymphedema definitions and assessment methods varied across the included studies, most commonly employing clinical grading. Methodological quality was mixed, reflecting the predominantly retrospective, single\u2010arm nature of the available evidence. Overall certainty of evidence was very low. Funnel plot inspection and Egger's test suggested small\u2010study effects (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lymphedema affects nearly half of patients following radiation for head and neck cancer. These findings may support routine surveillance, early identification, and timely referral for lymphedema management within survivorship care pathways. Future prospective studies should adopt standardized definitions and outcome measures to refine risk estimates and guide prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>N\/A.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70955","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:10:38Z","timestamp":1791335438000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Radiation\u2010Associated Lymphedema in Head and Neck Cancer: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9427-1914","authenticated-orcid":false,"given":"Austin R.","family":"Swisher","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3587-9732","authenticated-orcid":false,"given":"Evani","family":"Patel","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"India","family":"Casaday","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darby","family":"Keirns","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2674-3430","authenticated-orcid":false,"given":"Jessica W.","family":"Gregor","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head &amp; Neck Surgery Mayo Clinic  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. 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