Endometrial cancer: sentinel lymph node mapping cuts lower-extremity lymphedema risk

  • Leitao Jr. MM & et al.
  • Gynecol Oncol
  • 25 Nov 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In patients with newly diagnosed endometrial cancer, lymph node dissection (LND) is associated with a higher risk for lower-extremity lymphedema (LEL) vs sentinel lymph node (SLN) mapping.

Why this matters

  • LND is the standard treatment but failed to improve survival in 2 randomized trials.
  • The findings support SLN mapping as an alternative to LND.

Study design

  • 599 patients with endometrial cancer who underwent primary surgery completed a 13-item LEL patient-reported outcomes questionnaire.
  • Funding: National Institutes of Health/National Cancer Institute Memorial Sloan Kettering Cancer Center.

Key results

  • 37% of patients reported LEL.
  • External-beam radiation therapy (EBRT) was used in 5.6% of patients with SLN mapping and 9.9% of those who underwent LND.
  • Self-reported LEL rate was 27.2% in the SLN vs 40.9% in the LND group (OR, 1.85; P=.002).
  • LEL prevalence was 51.1% in patients who received EBRT and 34.9% in those who did not (OR, 1.95; P=.03).
  • High BMI was associated with an increased prevalence of LEL (OR, 1.04; P=.001).
  • After controlling for EBRT and BMI, LND remained an independent risk factor for LEL vs SLN (OR, 1.81; P=.003).
  • Patients with self-reported LEL had significantly worse QoL vs those without (P<.001>

Limitations

  • Survey-based study.