Sentinel lymph node (SLN) mapping leads to significantly less lower-extremity lymphedema compared to comprehensive lymphadenectomy (LND) after hysterectomy in patients with endometrial cancer, according to our research published recently in the journal Gynecology Oncology. Our study is the first to assess patient-reported lower-extremity lymphedema after SLN mapping for endometrial cancer.

We asked 1,275 patients to respond to a validated screening questionnaire. Among 599 evaluable respondents, the prevalence of self-reported lower-extremity lymphedema (LEL) was 27 percent (49 of 180 patients) in the SLN group, significantly lower than 41 percent (144 of 352 patients) in the LND group. The odds ratio (OR) of reporting lymphedema with LND versus SLN was 1.85 (95 percent CI, 1.25 to 2.74; p = 0.002). Higher body mass index (BMI) and the use of adjuvant external-beam radiotherapy were associated with an increased prevalence of lymphedema.

Overall, our findings provide additional support for SLN mapping in women with endometrial cancer, not only for accurate staging but also to decrease morbidity due to lymphedema and improve their quality of life after surgery. Our data may also inform discussions about the risks and benefits of adjuvant radiation therapy in this patient population.

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Doctors have known for a long time that cancer survivors may be at risk of a rare aftershock: developing a secondary leukemia years or even decades later. Because some chemotherapy drugs can damage the DNA in the bone marrow, where leukemia forms, experts have assumed that the drugs trigger the formation of cancerous blood cells that lead to leukemia.

A new study of people with breast cancer treated at Memorial Sloan Kettering is turning that idea on its head. The findings suggest that in some people, leukemia-causing gene mutations may be present in blood cells from the time that breast cancer is originally diagnosed, before chemotherapy is ever given. Although this discovery is important, the study looked at only a small group of patients, so larger studies are needed to confirm the findings.

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Human papillomavirus (HPV)–associated oropharyngeal cancer is on the rise, but at Memorial Sloan Kettering Cancer Center, we have updated our standard of care to substantially reduce the radiation dose to elective regions.

In our paper, published recently in the journal Practical Radiation Oncology, we summarize our current standard dose prescriptions and explain the rationale for our choices. Our recommendations are based on the American Joint Committee on Cancer Seventh Edition tumor-node-metastasis staging system. Note that these recommendations apply only to patients who receive concurrent platinum-based chemotherapy and who test positive in both p16 immunohistochemistry and HPV RNA in situ hybridization tests.

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