Patient-reported outcomes after surgery for endometrial carcinoma: Prevalence of lower-extremity lymphedema after sentinel lymph node mapping versus lymphadenectomy Journal Article


Authors: Leitao, M. M. Jr; Zhou, Q. C.; Gomez-Hidalgo, N. R.; Iasonos, A.; Baser, R.; Mezzancello, M.; Chang, K.; Ward, J.; Chi, D. S.; Long Roche, K.; Sonoda, Y.; Brown, C. L.; Mueller, J. J.; Gardner, G. J.; Jewell, E. L.; Broach, V.; Zivanovic, O.; Dowdy, S. C.; Mariani, A.; Abu-Rustum, N. R.
Article Title: Patient-reported outcomes after surgery for endometrial carcinoma: Prevalence of lower-extremity lymphedema after sentinel lymph node mapping versus lymphadenectomy
Abstract: Objective: To compare the prevalence of patient-reported lower-extremity lymphedema (LEL) with sentinel lymph node (SLN) mapping versus comprehensive lymph node dissection (LND) for the surgical management of newly diagnosed endometrial carcinoma. Methods: Patients who underwent primary surgery for endometrial cancer from 01/2006-12/2012 were mailed a survey that included a validated 13-item LEL screening questionnaire in 08/2016. Patients diagnosed with LEL prior to surgery and those who answered ≤6 survey items were excluded. Results: Of 1275 potential participants, 623 (49%) responded to the survey and 599 were evaluable (180 SLN, 352 LND, 67 hysterectomy alone). Median BMI was similar among cohorts (P = 0.99). External-beam radiation therapy (EBRT) was used in 10/180 (5.5%) SLN and 35/352 (10%) LND patients (P = 0.1). Self-reported LEL prevalence was 27% (49/180) and 41% (144/352), respectively (OR, 1.85; 95% CI, 1.25–2.74; P = 0.002). LEL prevalence was 51% (23/45) in patients who received EBRT and 35% (170/487) in those who did not (OR, 1.95; 95% CI, 1.06–3.6; P = 0.03). High BMI was associated with increased prevalence of LEL (OR, 1.04; 95% CI, 1.02–1.06; P = 0.001). After controlling for EBRT and BMI, LND retained independent association with an increased prevalence of LEL over SLN (OR, 1.8; 95% CI, 1.22–2.69; P = 0.003). Patients with self-reported LEL had significantly worse QOL compared to those without self-reported LEL. Conclusions: This is the first study to assess patient-reported LEL after SLN mapping for endometrial cancer. SLN mapping was independently associated with a significantly lower prevalence of patient-reported LEL. High BMI and adjuvant EBRT were associated with an increased prevalence of patient-reported LEL. © 2019 Elsevier Inc.
Keywords: adult; controlled study; aged; middle aged; cancer surgery; major clinical study; multimodality cancer therapy; conference paper; cancer patient; endometrial cancer; endometrioid carcinoma; endometrium carcinoma; hysterectomy; lymph node dissection; sentinel lymph node mapping; sentinel lymph node; sentinel lymph node biopsy; lymphadenectomy; quality of life; prevalence; cohort analysis; cancer screening; health survey; self report; lymphedema; questionnaire; body mass; peripheral edema; external beam radiotherapy; patient-reported outcomes; postal mail; carcinosarcoma; endometrium sarcoma; patient-reported outcome; human; female; priority journal; endometrium carcinosarcoma; european organization for research and treatment of cancer quality of life questionnaire core 30; lower extremity lymphedema
Journal Title: Gynecologic Oncology
Volume: 156
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2020-01-01
Start Page: 147
End Page: 153
Language: English
DOI: 10.1016/j.ygyno.2019.11.003
PUBMED: 31780238
PROVIDER: scopus
PMCID: PMC6980687
DOI/URL:
Notes: Conference Paper -- Export Date: 3 February 2020 -- Source: Scopus
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MSK Authors
  1. Ginger J Gardner
    204 Gardner
  2. Raymond E Baser
    97 Baser
  3. Elizabeth Jewell
    97 Jewell
  4. Carol Brown
    148 Brown
  5. Dennis S Chi
    589 Chi
  6. Yukio Sonoda
    365 Sonoda
  7. Mario Leitao
    434 Leitao
  8. Oliver Zivanovic
    207 Zivanovic
  9. Qin Zhou
    169 Zhou
  10. Alexia Elia Iasonos
    254 Iasonos
  11. Kara Christine Long
    138 Long
  12. Jae Huh
    17 Huh
  13. Kaity Chang
    7 Chang
  14. Jennifer Jean Mueller
    95 Mueller
  15. Vance Andrew Broach
    50 Broach