SENTIREC – The sentinel node mapping in women with cervical cancer study – Patient-reported early lymphedema and its impact on quality of life

• Published in: Gynecologic oncology Vol. 164; no. 3; pp. 463 - 472
• Main Authors: Sponholtz, Sara Elisabeth, Ezendam, Nicole P.M., de Rooij, Belle H., Parner, Erik, Mogensen, Ole, Hildebrandt, Malene Grubbe, Schledermann, Doris, Markauskas, Algirdas, Frøding, Ligita Paskeviciute, Fuglsang, Katrine, Bjørnholt, Sarah Marie, Jensen, Pernille Tine
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2022
• Subjects: Cervical cancer; Female; Humans; Lymph Node Excision - adverse effects; Lymph Nodes - pathology; Lymphedema; Lymphedema - epidemiology; Lymphedema - etiology; Lymphedema - pathology; Neoplasm Staging; Patient Reported Outcome Measures; Prospective Studies; Quality of Life; Sentinel lymph node; Sentinel Lymph Node - pathology; Sentinel Lymph Node - surgery; Sentinel Lymph Node Biopsy - methods; Surgical oncology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery; Patient reported outcome measures; Surgical oncology; Lymphedema; Sentinel lymph node; Cervical cancer; Quality of life
• ISSN: 0090-8258; 1095-6859; 1095-6859
• DOI: 10.1016/j.ygyno.2021.12.024

To evaluate patient-reported incidence and severity of early lymphedema and its impact on quality of life (QoL) after sentinel lymph node (SLN) mapping only and after SLN and pelvic lymphadenectomy (PL) in women undergoing surgery for early-stage cervical cancer. In a national prospective multicenter study, we included women with early-stage cervical cancer from March 2017–January 2021 to undergo radical surgery including SLN mapping. Women with tumors >20 mm underwent completion PL. The incidence and severity of early lymphedema and its influence on QoL were evaluated using validated patient-reported outcome measures before surgery and three months postoperative. We investigated changes over time using linear regression. Two hundred of 245 (81.6%) included women completed questionnaires at baseline and three months postoperatively. The incidence of early lymphedema was 5.6% (95% CI 2.1–11.8%) and 32.3% (95% CI 22.9–42.7%) in women who underwent SLN mapping only and SLN + PL, respectively. Lymphedema symptoms in the legs, genitals, and groins increased in both groups postoperatively but three times more in women who underwent PL. Lymphedema symptoms after SLN + PL significantly impaired physical performance (p = 0.001) and appearance (p = 0.007). Reporting lymphedema was significantly associated with impaired body image, physical-, role-, and social functioning, and a high level of fatigue. SLN mapping alone carries a low risk of lymphedema in women undergoing surgery for early-stage cervical cancer. In contrast, completion PL is associated with a high incidence of early lymphedema. Reporting lymphedema is associated with significant impairment of several physical, psychological, and social aspects of QoL. [Display omitted] •Sentinel node mapping only is associated with a low risk of self-reported lymphedema after surgery for cervical cancer.•Sentinel node mapping combined with pelvic lymphadenectomy is associated with a high incidence of early lymphedema.•Lymphedema symptoms after pelvic lymphadenectomy significantly impaired physical performance and appearance.•Reporting early lymphedema is significantly associated with impairment in several quality of life domains and symptoms.