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.