Comparison of leg volume ratio between inguinal lymphadenectomy and inguino-pelvic lymphadenectomy in patients with skin cancer of the lower extremity

Abstract

Background

The timing of intervention to treat lymphedema differs among facilities. Understanding differences in the prevalence and severity of lymphedema following different surgical procedures for lymphadenectomy could promote early intervention to treat lymphedema. There is currently little evidence to support the notion that inguino-pelvic lymphadenectomy is associated with greater morbidity than inguinal lymphadenectomy, although it is believed that the difference in the extent of surgery results in a difference in the severity of lymphedema. In this study, we compared volume percentage change between inguinal lymphadenectomy and inguino-pelvic lymphadenectomy in patients with skin cancer of the lower extremity.

Patients and methods

A total of 29 patients with skin cancer of a lower extremity who underwent lymphadenectomy were classified into an inguinal lymphadenectomy group and an inguino-pelvic lymphadenectomy group. The increase in the volume of the affected side compared with that of the unaffected side in the whole lower extremity, thigh, and lower leg was calculated on volume-rendered computed tomography images.

Results

The mean volume percentage increase in the inguinal lymphadenectomy group and the inguino-pelvic lymphadenectomy group was, respectively, 6.72% and 11.18% in the whole lower extremity and 7.30% and 2.55% in the lower leg, showing no statistically significant differences. In contrast, the mean volume percentage increase in the respective groups was 7.03% and 19.78% in the thigh, showing a statistically significant difference (p = 0.0275 < 0.05).

Conclusions

The findings of this study indicate that the leg volume of the whole lower extremity may not have worse outcomes in inguino-pelvic lymphadenectomy compared with inguinal lymphadenectomy.