Lower-Limb Lymphedema after Sentinel Lymph Node Biopsy in Cervical Cancer Patients.
cervical cancer
lower limb lymphedema
pelvic lymphadenectomy
sentinel lymph node biopsy
Journal
Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829
Informations de publication
Date de publication:
13 May 2021
13 May 2021
Historique:
received:
06
04
2021
revised:
07
05
2021
accepted:
11
05
2021
entrez:
2
6
2021
pubmed:
3
6
2021
medline:
3
6
2021
Statut:
epublish
Résumé
To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND. A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI) between pre- and postoperative measurements, and subjective patient-perceived swelling were conducted in six-month periods over 24-months post-surgery. The cumulative incidence of LLL at 24 months was 17.3% for mild LLL (LVI 10-19%), 9.2% for moderate LLL (LVI 20-39%), while only one patient (0.7%) developed severe LLL (LVI > 40%). The median interval to LLL onset was nine months. Transient edema resolving without intervention within six months was reported in an additional 22% of patients. Subjective LLL was reported by 10.7% of patients, though only a weak and partial correlation between subjective-report and objective-LVI was found. No risk factor directly related to LLL development was identified. The replacement of standard PLND by bilateral SLN biopsy in the surgical treatment of cervical cancer does not eliminate the risk of mild to moderate LLL, which develops irrespective of the number of SLN removed.
Sections du résumé
BACKGROUND
BACKGROUND
To prospectively assess LLL incidence among cervical cancer patients treated by uterine surgery complemented by SLN biopsy, without PLND.
METHODS
METHODS
A prospective study in 150 patients with stage IA1-IB2 cervical cancer treated by uterine surgery with bilateral SLN biopsy. Objective LLL assessments, based on limb volume increase (LVI) between pre- and postoperative measurements, and subjective patient-perceived swelling were conducted in six-month periods over 24-months post-surgery.
RESULTS
RESULTS
The cumulative incidence of LLL at 24 months was 17.3% for mild LLL (LVI 10-19%), 9.2% for moderate LLL (LVI 20-39%), while only one patient (0.7%) developed severe LLL (LVI > 40%). The median interval to LLL onset was nine months. Transient edema resolving without intervention within six months was reported in an additional 22% of patients. Subjective LLL was reported by 10.7% of patients, though only a weak and partial correlation between subjective-report and objective-LVI was found. No risk factor directly related to LLL development was identified.
CONCLUSIONS
CONCLUSIONS
The replacement of standard PLND by bilateral SLN biopsy in the surgical treatment of cervical cancer does not eliminate the risk of mild to moderate LLL, which develops irrespective of the number of SLN removed.
Identifiants
pubmed: 34068399
pii: cancers13102360
doi: 10.3390/cancers13102360
pmc: PMC8153612
pii:
doi:
Types de publication
Journal Article
Langues
eng
Subventions
Organisme : Univerzita Karlova v Praze
ID : UNCE 204065
Organisme : Univerzita Karlova v Praze
ID : PROGRES Q28/LF1
Organisme : Czech Health research Council
ID : NV19-03-00023
Références
Gynecol Oncol. 2010 May;117(2):317-23
pubmed: 20163847
World J Surg Oncol. 2018 Apr 10;16(1):75
pubmed: 29631609
Cancer Epidemiol Biomarkers Prev. 2017 Apr;26(4):444-457
pubmed: 28223433
Arch Gynecol Obstet. 2019 Apr;299(4):1033-1041
pubmed: 30488281
Gynecol Oncol. 2006 Nov;103(2):714-8
pubmed: 16740298
Int J Gynecol Cancer. 2020 Feb;30(2):252-260
pubmed: 31915136
Gynecol Oncol. 2019 May;153(2):399-404
pubmed: 30879878
Support Care Cancer. 2013 Nov;21(11):3063-70
pubmed: 23812496
Ann Surg. 2008 Aug;248(2):286-93
pubmed: 18650640
Lancet Oncol. 2011 Feb;12(2):192-200
pubmed: 20619737
Anticancer Res. 2017 Aug;37(8):4005-4015
pubmed: 28739682
Int J Gynecol Cancer. 2013 Nov;23(9):1717-25
pubmed: 24172106
J Obstet Gynaecol Res. 2010 Jun;36(3):555-9
pubmed: 20598037
Gynecol Oncol. 2010 Oct;119(1):60-4
pubmed: 20638109
Front Surg. 2020 Jun 12;7:31
pubmed: 32596252
Lancet Oncol. 2019 Sep;20(9):1316-1326
pubmed: 31383547
Lymphology. 2016 Dec;49(4):170-84
pubmed: 29908550
Int J Clin Oncol. 2020 May;25(5):963-971
pubmed: 31907719
Int J Gynecol Cancer. 2020 Jun;30(6):757-763
pubmed: 32107315
Jpn J Clin Oncol. 2020 May 5;50(5):543-547
pubmed: 32104889
Eur J Surg Oncol. 2020 Jul;46(7):1334-1338
pubmed: 32146054
BMC Womens Health. 2017 Jul 25;17(1):50
pubmed: 28743274
Gynecol Oncol. 2015 Nov;139(2):295-9
pubmed: 26363210
Int J Gynecol Cancer. 2012 Sep;22(7):1244-50
pubmed: 22864335
Int J Gynecol Cancer. 2015 May;25(4):699-706
pubmed: 25664439
Medicine (Baltimore). 2018 Apr;97(14):e0331
pubmed: 29620659
Support Care Cancer. 2013 Aug;21(8):2207-15
pubmed: 23494582
Jpn J Clin Oncol. 2018 Dec 1;48(12):1036-1040
pubmed: 30329065
J Minim Invasive Gynecol. 2020 May - Jun;27(4):938-945.e2
pubmed: 31421249
Int J Gynecol Cancer. 2015 Mar;25(3):521-5
pubmed: 25621410
Int J Clin Oncol. 2011 Jun;16(3):238-43
pubmed: 21213009
Gynecol Oncol. 2017 Sep;146(3):623-629
pubmed: 28624154
J Am Acad Dermatol. 2017 Dec;77(6):1009-1020
pubmed: 29132848
Acta Obstet Gynecol Scand. 2019 Nov;98(11):1404-1412
pubmed: 31237957
Gynecol Oncol. 2020 Feb;156(2):467-474
pubmed: 31837831
Lymphology. 2020;53(1):3-19
pubmed: 32521126
Strahlenther Onkol. 2008 Apr;184(4):206-11
pubmed: 18398585
Int J Gynecol Cancer. 2015 May;25(4):751-7
pubmed: 25723779
Gynecol Oncol. 2017 Aug;146(2):292-298
pubmed: 28526168
Gynecol Oncol. 2015 Jan;136(1):87-93
pubmed: 25448454
Int J Gynecol Cancer. 2010 Jul;20(5):900-4
pubmed: 20606541
Gynecol Oncol. 2015 Oct;139(1):160-4
pubmed: 26186910
Gynecol Oncol. 2019 Dec;155(3):452-460
pubmed: 31679787
Arch Pathol Lab Med. 2019 Dec 23;:
pubmed: 31869245
Surg Oncol. 2016 Sep;25(3):200-4
pubmed: 27566023
Ann Surg Oncol. 2016 Jan;23(1):203-10
pubmed: 26059654
Int J Gynaecol Obstet. 2009 May;105(2):103-4
pubmed: 19367689
Sci Rep. 2020 Jun 12;10(1):9583
pubmed: 32533117
Eur J Cancer. 2020 Sep;137:69-80
pubmed: 32750501
Radiother Oncol. 2018 Jun;127(3):449-455
pubmed: 29631933
BJOG. 2014 Nov;121(12):1538-45
pubmed: 24735243
Int J Clin Oncol. 2018 Dec;23(6):1167-1172
pubmed: 30094694
Cancer. 2007 Jun 15;109(12):2607-14
pubmed: 17474128
Medicine (Baltimore). 2017 Nov;96(46):e8722
pubmed: 29145314
Int J Gynecol Cancer. 2010 Apr;20(3):476-8
pubmed: 20375816
Gynecol Oncol. 2018 Mar;148(3):491-498
pubmed: 29273307