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EPV049/#254 Patient-reported lower limb lymphedema and quality of life after radical surgery with sentinel node mapping for early-stage cervical cancer
  1. S Sponholtz1,2,
  2. O Mogensen3,4,
  3. M Hildebrandt2,5,6,
  4. D Schledermann2,7,
  5. E Parner8,
  6. N Ezendam9,
  7. A Markauskas1,
  8. L Frøding10,
  9. K Fuglsang3,
  10. S Bjørnholt3,4 and
  11. P Jensen2,3,4
  1. 1Odense University Hospital, Department of Gynecology and Obstetrics, Odense C, Denmark
  2. 2University of Southern Denmark, Department of Clinical Research, Odense C, Denmark
  3. 3Aarhus University Hospital, Department of Gynecology and Obstetrics, Aarhus N, Denmark
  4. 4Aarhus University, Institute of Clinical Medicine, Aarhus, Denmark
  5. 5Odense University Hospital, Department of Nuclear Medicine, Odense C, Denmark
  6. 6Odense University Hospital and University of Southern Denmark, Center For Innovative Medical Technology, Odense C, Denmark
  7. 7Odense University Hospital, Department of Pathology, Odense C, Denmark
  8. 8Aarhus University, Department of Public Health, Aarhus, Denmark
  9. 9The Netherlands Comprehensive Cancer Organization, (iknl), Amsterdam, Netherlands
  10. 10Copenhagen University Hospital, Department of Gynecology, Copenhagen, Denmark


Objectives We prospectively evaluated patient-reported lower limb lymphedema and quality of life (QoL) in women with early-stage cervical cancer undergoing radical surgery with sentinel lymph node (SLN) mapping.

Methods In a national multi-institutional 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 pelvic lymphadenectomy (PL). The incidence and severity of lymphedema and QoL were evaluated using validated patient-reported outcome measures before surgery and three months postoperative. Changes over time were investigated using linear regression.

Results Two hundred of 245 (81.6%) included women completed the baseline and three-month questionnaires. The incidence of lymphedema was 7.2% versus 31.5% in women who underwent SLN mapping alone and completion PL, respectively (p < 0.001). Lymphedema scores in the leg, genital, and groin were affected in both groups, but significantly more after PL. The differences between groups remained significant in a multivariate analysis adjusting for, e.g., adjuvant therapy and age. PL significantly affected the severity of lymphedema regarding physical performance (p = 0.001), appearance (p = 0.008), besides heaviness, weakness, and pain in the legs (p < 0.001). Lymphedema was negatively associated with impaired body image, physical, role, and social functioning and a higher level of fatigue.

Conclusions SLN mapping combined with PL is associated with a significantly higher incidence and more severe lymphedema three months postoperatively than SLN mapping alone. Lymphedema was associated with lower QoL in several domains.

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