- 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.
- 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.
- 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>
- Survey-based study.