Objective: 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. Methods: 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. Results: 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. Conclusions: 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.
Bibliografisk noteFunding Information:
The project was funded by The University of Southern Denmark , Odense University Hospital Denmark , The Danish Cancer Society , The Danish Cancer Research Foundation , Copenhagen University Hospital , Carpenter Axel Kastrup-Nielsen's Fund , Eva and Henry Fraenkel's Fund , King Christian the 10th's fund , and Frimodt-Heineke's Fund . The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of data; preparation; review, or approval of the manuscript; and decision to submit the manuscript for publication.
© 2021 The Authors