{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T06:04:43Z","timestamp":1790229883671,"version":"4.1.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower-extremity lymphedema (LEL) is a chronic complication after gynecological cancer surgery. Obesity may aggravate lymphatic dysfunction and reduce the effectiveness of standard physical management. We evaluated a BMI-stratified integrated intervention informed by a meridian-lymph conceptual framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 60 patients with gynecological cancer-related LEL were randomly assigned in a 1:1 ratio to an intervention group (n=30) or a control group (n=30). The intervention group received BMI-stratified meridian massage and dietary and health guidance for 6 months, whereas the control group received compression stockings, health education, and aerobic exercise. Patients were divided into three subgroups by BMI: &amp;lt;24 kg\/m\u00b2, 24\u201327.9 kg\/m\u00b2, and \u226528 kg\/m\u00b2. The primary outcome was change in affected-limb volume, and quality of life was assessed using LYMQOL. Outcome assessors were blinded to group allocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At 6 months, affected-limb volume decreased by 32.1\u00a0\u00b1\u00a06.2% in the intervention group and 14.3\u00a0\u00b1\u00a05.8% in the control group (P&amp;lt;0.01). LYMQOL scores improved by 15.2\u00a0\u00b1\u00a03.1 and 6.8\u00a0\u00b1\u00a02.9 points, respectively (P&amp;lt;0.01). Exploratory subgroup analysis suggested a greater volume reduction among participants with BMI \u226528 kg\/m\u00b2 than among those with BMI 24-27.9 kg\/m\u00b2 (P\u00a0=\u00a00.02). Three participants in the intervention group developed transient skin redness, and no serious adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with LEL after gynecological cancer surgery, the BMI-stratified integrated intervention was associated with greater improvement in limb volume and quality of life than conventional care over 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>\n                      , identifier NCT07374835.\n                    <\/jats:p>\n                  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