Objectives To evaluate the rate of lymphatic-related morbidity among patients undergoing surgical staging for apparent early-stage ovarian cancer (EOC) and to report the specific patients’ lymphatic complications.

Methods Data of consecutive patients who underwent surgical staging for EOC between 01/2002 and 12/2018 were analyzed. A self-reported validated 13-item lymphedema screening questionnaire was sent to evaluate specific lymphatic complications. Patients were stratified by the performance retroperitoneal staging into two groups: fully pelvic and aortic lymphadenectomy performed (LND) vs. no retroperitoneal staging (NO-LND). Patients who had conservative treatment were included in the study. The analysis focused only on women who answered the specific questionnaire. Patients lost at follow-up and those who reported peripheral vascular disease at the time of surgery were excluded.

Results During the study period 140 patients were treated; according to the inclusion/exclusion criteria 107 represented our study population. Baseline characteristics such as age, BMI, Charlson Comorbidity Index (CCI) and surgical approach did not significantly differ between the groups. Patients in LND group (compared to NO-LND) had a higher rate of specific lymphatic complications (26.6% vs. 0%, p <0.01). The performance of lymphadenectomy significantly impacted the subjective lymphatic-related morbidity (score >5).

Conclusions Our study confirms a high correlation between the performance of LND and specific lymphatic morbidity in patients undergoing surgical staging for EOC. The dedicated 13-item screening questionnaire might be a useful tool to categorize patients’ perception of lymphatic-related complications, including lower extremity lymphedema.