TY - JOUR
T1 - Patient-reported outcomes after surgery for endometrial carcinoma
T2 - Prevalence of lower-extremity lymphedema after sentinel lymph node mapping versus lymphadenectomy
AU - Leitao, Mario M.
AU - Zhou, Qin C.
AU - Gomez-Hidalgo, Natalia R.
AU - Iasonos, Alexia
AU - Baser, Ray
AU - Mezzancello, Marissa
AU - Chang, Kaity
AU - Ward, Jae
AU - Chi, Dennis S.
AU - Long Roche, Kara
AU - Sonoda, Yukio
AU - Brown, Carol L.
AU - Mueller, Jennifer J.
AU - Gardner, Ginger J.
AU - Jewell, Elizabeth L.
AU - Broach, Vance
AU - Zivanovic, Oliver
AU - Dowdy, Sean C.
AU - Mariani, Andrea
AU - Abu-Rustum, Nadeem R.
N1 - Funding Information:
This study was supported in part by the National Institutes of Health/National Cancer Institute Memorial Sloan Kettering Cancer Center Support Grant P30 CA008748 (Drs. Leitao, Iasonos, Baser, Chi, Long Roche, Sonoda, Brown, Mueller, Gardner, Jewell, Broach, Zivanovic, and Abu-Rustum).
Funding Information:
This study was supported in part by the National Institutes of Health / National Cancer Institute Memorial Sloan Kettering Cancer Center Support Grant P30 CA008748 (Drs. Leitao, Iasonos, Baser, Chi, Long Roche, Sonoda, Brown, Mueller, Gardner, Jewell, Broach, Zivanovic, and Abu-Rustum).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2020/1
Y1 - 2020/1
N2 - 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.
AB - 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.
KW - Endometrial cancer
KW - Lymphadenectomy
KW - Lymphedema
KW - Patient-reported outcomes
KW - Sentinel lymph node
KW - Sentinel lymph node mapping
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U2 - 10.1016/j.ygyno.2019.11.003
DO - 10.1016/j.ygyno.2019.11.003
M3 - Article
C2 - 31780238
AN - SCOPUS:85076010369
SN - 0090-8258
VL - 156
SP - 147
EP - 153
JO - Gynecologic oncology
JF - Gynecologic oncology
IS - 1
ER -