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

Abstract

h i g h l i g h t s SLN mapping was independently associated with significantly lower rate of patient-reported lower extremity lymphedema (LEL). Increasing BMI and use of adjuvant EBRT were associated with an increased prevalence of patient-reported LEL. SLN mapping in the surgical management of newly diagnosed endometrial cancer may spare these patients from LEL. Survival outcomes were similar between SLN mapping and comprehensive lymphadenectomy after endometrial cancer surgery.

The Quality of Life and Psychosocial Implications of Cancer-Related Lower-Extremity Lymphedema: A Systematic Review of the Literature

“…The calculated mean age of participants across all studies was 60.7 years and participants were mostly women with a history of gynecological cancer. Studies were conducted in the USA ( n = 7), Australia ( n = 6), the Republic of Korea ( n = 2), Brazil ( n = 1), Denmark ( n = 1), Italy ( n = 1), Japan ( n = 1), Sweden ( n = 1) and the United Kingdom ( n = 1) [ 5 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ].…”

“…Overall, the studies were primarily cross-sectional ( n = 6) [ 38 , 39 , 40 , 41 , 42 , 43 ], prospective cohort studies ( n = 6) [ 24 , 25 , 26 , 30 , 31 , 32 ], retrospective cohort studies ( n = 6) [ 5 , 27 , 28 , 29 , 33 , 35 ], and case–control studies ( n = 3) [ 23 , 34 , 36 ]. Study design was also assessed based upon the specific methodology implemented when investigating LEL in relation to QOL/psychosocial well-being, which in some cases was different than the overall study design.…”

“…Study design was also assessed based upon the specific methodology implemented when investigating LEL in relation to QOL/psychosocial well-being, which in some cases was different than the overall study design. This sub-analysis revealed cross-sectional ( n = 16) [ 5 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 34 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ], prospective cohort ( n = 3) [ 30 , 31 , 32 ], and retrospective cohort ( n = 2) [ 33 , 35 ] methodologies.…”

“…Cancer-related LEL was most often identified through self-reported questionnaires ( n = 13) [ 5 , 19 , 23 , 25 , 27 , 29 , 30 , 32 , 36 , 37 , 38 , 39 , 42 ], of which four reported questionnaire validity and five incorporated a secondary clinical assessment. Limb volume and tissue changes assessed by a health care provider were also used for LEL identification ( n = 4) [ 24 , 30 , 40 , 41 , 42 ], formal clinical diagnosis ( n = 2) [ 32 , 44 ], and clinical examination with lymphatic imaging ( n = 2) [ 40 , 42 ].…”

“…Three articles did not report on lymphedema identification criteria [ 26 , 27 , 28 ]. The majority of studies ( n = 14) focused on QOL (global or HRQOL) and/or one or more psychosocial domains as the primary study aim [ 5 , 24 , 26 , 27 , 28 , 30 , 31 , 33 , 35 , 36 , 37 , 40 , 41 , 42 ], while the remaining seven studies focused on cancer-related LEL prevalence/incidence as the primary aim, with psychosocial measures as secondary outcomes [ 23 , 25 , 29 , 32 , 34 , 38 , 39 ]. In order to assess dimensions of QOL and psychosocial well-being, studies either used one or more of the following measures: twelve studies used the European Organisation for Research and Treatment of Cancer (EORTC) instruments, five used Functional Assessments of Chronic Illness Therapy (FACIT) tools, four used the Hospital Anxiety and Depression Scale (HADS), three used the Medical Outcomes Survey Short Form-12 (MOS SF-12), and two used the Gynecologic Cancer Lymphedema Questionnaire (GCLQ).…”