Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients

Cibula, David; Borčinová, Martina; Marnitz, Simone; Jarkovský, Jiří; Klát, Jaroslav; Pilka, R; Torné, Aureli; Zapardiel, Ignacio; Petiz, Almerinda; Lay, Laura; Sehnal, Borek; Ponce, Jordi; Felsinger, Michal; Arencibia-Sánchez, Octavio; Kaščák, Peter; Zalewski, Kamil; Presl, J; Palop-Moscardó, Alicia; Tingulstad, Solveig; Vergote, Ignace; Redecha, M; Frühauf, F.; Köhler, Christian; Kocián, Roman

doi:10.3390/cancers13102360

Cited by 16 publications

(9 citation statements)

References 54 publications

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“…The sentinel lymph node (SLN) biopsy has emerged as an alternative to complete lymphadenectomy, with an overall detection rate over 80% and a specificity of 100% [34]. Although surgical complication rate appears to be reduced when SLN biopsy is performed compared to lymphadenectomy [35], they are not zero [36]. Lymph node dissection prolongs the duration of surgery, the risk of pre-and post-operative complications and may be difficult to complete in obese patients with prior surgeries or patients with major co-morbidities.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers Associated with Lymph Nodal Metastasis in Endometrioid Endometrial Carcinoma

Mairé

Bourdon

Soubeyran

et al. 2022

Cancers

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Introduction. Lymph node metastasis is determinant in the prognosis and treatment of endometrioid endometrial cancer (EEC) but the risk–benefit balance of surgical lymph node staging remains controversial. Objective. Describe the pathways associated with lymph node metastases in EEC detected by whole RNA sequencing. Methods. RNA-sequencing was performed on a retrospective series of 30 non-metastatic EEC. N+ and N− patients were matched for tumoral size, tumoral grade and myometrial invasion. Results. Twenty-eight EECs were analyzable (16 N+ and 12 N−). Bioinformatics Unsupervised analysis revealed three patterns of expression, enriched in N+, mix of N+/N− and enriched in N−, respectively. The cluster with only N+ patient overexpressed extra cellular matrix, epithelial to mesenchymal and smooth muscle contraction pathways with respect to the N− profile. Differential expression analysis between N+ and N− was used to generate a 54-genes signature with an 87% accuracy. Conclusion. RNA-expression analysis provides a basis to develop a gene expression-based signature that could pre-operatively predict lymph node invasion.

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Section: Discussionmentioning

confidence: 99%

Biomarkers Associated with Lymph Nodal Metastasis in Endometrioid Endometrial Carcinoma

Mairé

Bourdon

Soubeyran

et al. 2022

Cancers

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“…Lymphedema is one of the more significant complications that can occur after a lymph node dissection of the axillary or inguinofemoral lymph nodes (34). Usually, these lymph node dissection schemes are performed in the context of node-positive breast cancer and melanoma (35).…”

Section: Discussionmentioning

confidence: 99%

Quality of Life Predictors in Patients With Melanoma: A Machine Learning Approach

et al. 2022

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Health related quality of life (HRQoL) is an important recognized health outcome for cancer treatments, but also disease course with slower recovery and increased morbidity. These issues are of implication in melanoma, which maintains a risk of disease progression for many years after diagnosis. This study aimed to explore and weigh factors in the perception of the quality of life and possible relationships with demographic–clinical characteristics in people with melanoma via a machine learning approach. In this observational study, patients with melanoma, without metastatic disease, were recruited from January 2020 to December 2021 with a follow-up of at least one year. Demographic variables and clinics were collected, and the 12-Item Short-Form Health Survey (SF-12) was adopted as the physical and mental aspects of the Health-Related Quality of Life (HRQoL) measure. All the variables were processed in a random forest model to weigh at each node of each tree of this machine learning regression model, their actual weight in SF-12 score. We included 203 melanoma patients, mean aged 59.25 ± 15.1 years: 56 (27%) affecting the upper limbs and 147 (73%) affecting the trunk. The model of 142 patients with no missing value, generating 92 trees (MSE = 0.45, R2 of 0.78), reported that the lesion site was the most influencing variable on HRQoL based on the decrease in Gini impurity in variable weighing at each node intersection in forest generation. In this scenario, we built two distinct models for lesion sites and demonstrated that the variable that most influenced the quality of life in upper limb melanoma was lymphedema, while BMI was in the trunk. Given these results, random forest regressions could play a crucial role in the clinical and rehabilitation approach. The machine-learning model for detecting the HRQoL predictor in melanoma patients indicates that the experienced lymphedema and BMI may influence the HRQoL perception. This study suggests that the prevention and treatment of lymphedema and bodyweight reduction might improve the quality of life in melanoma.

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“…Groin lymph node flap has gained popularity amongst surgeons treating upper limb lymphedema, mainly due to its reliable vascular anatomy and lymph node quantity [ 20 ]. In spite of these favorable flap characteristics, special consideration is still needed, bearing in mind the potential for iatrogenic lower extremity lymphedema, even if the amount of lymph nodes is minimal [ 11 , 22 , 23 , 24 ]. It is appropriately expected that the removal of more LNs from the patient’s inguinal basin bears an increased risk of donor-site morbidity.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Lymph Node Transfer in Secondary Lymphedema and Its Correlation with Flap Characteristics

Dionyssiou

Sarafis

Tsimponis

et al. 2021

Cancers

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Background: This retrospective study aimed to assess the impact of certain flap characteristics on long-term outcomes following microsurgical treatment in Breast Cancer-Related Lymphedema (BCRL) patients. Methods: Sixty-four out of 65 BCRL patients, guided by the “Selected Lymph Node” (“SeLyN”) technique, underwent Vascularized Lymph Node Transfer (VLNT) between 2012 and 2018. According to their surface size, flaps were divided into small (<25 cm2, n = 32) and large (>25 cm2, n = 32). Twelve large and six small flaps were combined with free abdominally based breast reconstruction procedures. Lymphedema stage, flap size, vascular pedicle and number of lymph nodes (LNs) were analyzed in correlation with long-term Volume Differential Reduction (VDR). Results: At 36-month follow-up, no major complication was recorded in 64 cases; one flap failure was excluded from the study. Mean flap size was 27.4 cm2, mean LNs/flap 3.3 and mean VDR 55.7%. Small and large flaps had 2.8 vs. 3.8 LNs/flap (p = 0.001), resulting in 49.6% vs. 61.8% VDR (p = 0.032), respectively. Lymphedema stage and vascular pedicle (SIEA or SCIA/SCIP) had no significant impact on VDR. Conclusion: In our series, larger flaps included a higher number of functional LNs, directly associated with better outcomes as quantified by improved VDR.

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Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients

Cited by 16 publications

References 54 publications

Biomarkers Associated with Lymph Nodal Metastasis in Endometrioid Endometrial Carcinoma

Biomarkers Associated with Lymph Nodal Metastasis in Endometrioid Endometrial Carcinoma

Quality of Life Predictors in Patients With Melanoma: A Machine Learning Approach

Long-Term Outcomes of Lymph Node Transfer in Secondary Lymphedema and Its Correlation with Flap Characteristics

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