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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