A Prospective Study in Detection of Lower-Limb Lymphedema and Evaluation of Quality of Life After Vulvar Cancer Surgery

Abstract

Lower radicality in inguinofemoral lymphadenectomy shows a trend toward lower morbidity and significantly improves QoL. Multifrequency Bioelectrical Impedance Analysis was tested in these patients as a noninvasive, objective method for lymphedema detection. Detection of lymphedema based on subjective evaluations proved to have an unsatisfactory sensitivity. Less radical surgery showed objectively better results in QoL.

A Prospective Study in the Evaluation of Quality of Life After Vulvar Cancer Surgery

“…Sentinel lymph node biopsy in vulvar cancer is an efficient technique that helps reduce postsurgical morbidity. The lower prevalence of lymphedema after SLNB compared with inguinofemoral lymphadenectomy has been confirmed in other studies 6,7,18 and is similar to the relation between the number of dissected lymph nodes and the prevalence of lymphedema in breast cancer patients. 19 In accordance with other publications, we found a lower QoL in patients after radiotherapy.…”

The Lymphedema Evaluation in Gynecological cancer Study (LEGS): design of a prospective, longitudinal, cohort study

“…Retention rate for LEGS was high, with the majority of participants followed for up to two years following surgery (the maximum in the literature is to six months (39,40)). The length of followup will allow us to capture delayed development of the lymphedema, as has been documented in the breast cancer setting.…”

“…Current work investigating lower-limb LE following gynecological cancer is restricted by self-report LE assessment, retrospective study design and/or limited follow-up period (maximum follow-up period is six months postsurgery (39,40)). Lessons learnt from the breast cancer-related LE setting clearly demonstrate that to improve understanding of secondary LE, longitudinal, cohort studies with prospective and comprehensive LE assessment (including selfreport and objective measures) and follow-up of at least 24 months post-diagnosis are needed.…”

The Effect of Groin Treatment Modality and Sequence on Clinically Significant Chronic Lymphedema in Patients With Vulvar Carcinoma

“…Previous methods of reporting CL have included subjective swelling of the extremity, physical examination findings, referral to lymphedema clinics, leg circumference or volume measurements, and bioimpedance testing. 5,6 Recently, patient-reported symptom severity has been correlated to objective leg measurements with a questionnaire adapted from the validated Lymphedema and Breast Cancer Questionnaire. 7 These patient-centered outcome measures should allow for more meaningful assessment of the impact of this condition and treatment outcomes.…”

“…7 These patient-centered outcome measures should allow for more meaningful assessment of the impact of this condition and treatment outcomes. 6,8,9 Estimates of CL after treatment for vulvar cancer vary by the method of diagnosis and reporting, but range from 9% to 67%. 2,5,10Y15 Inguinal lymph node dissection and RT to the inguinal nodal bed are both individually well-established risk factors for the development of CL in vulvar cancer patients.…”