Impact of lymph node staging techniques on lymphedema and quality of life in early-stage endometrial cancer: A prospective cohort study

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-08-01 DOI:10.1016/j.gore.2025.101919

Anna Torrent , Joana Amengual , Angela Ruiz , Aina Serra , Laura Fuertes , Catalina Maria Sampol , Mario Ruiz , Jorge Rioja , Pilar Roca , Octavi Cordoba

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引用次数: 0

Abstract

Background

Sentinel lymph node (SLN) biopsy is increasingly replacing complete pelvic lymphadenectomy (CL) for staging early-stage endometrial cancer (EC), but its long-term impact on patients’ quality of life (QoL) and lymphedema remains underexplored.

Objective

To compare overall health perception (oHP), health-related QoL (HRQoL), and symptomatic lymphedema in patients staged with SLN versus CL. Secondary objectives included the assessment of symptomatic lymphedema and surgical complications.

Methods

We conducted a prospective single-center observational study including 97 patients treated early-stage EC, with 50 undergoing SLN plus CL and 47 undergoing SLN only. Patients completed EQ-5D-3L, oHP scale (0–100), and the self-reported lower-extremity lymphedema questionnaire (LELQ) at baseline and 6-month follow-up. Multivariate analysis adjusted for confounders including surgical approach and adjuvant therapy.

Results

At 6 months, the SLN group reported significantly better oHP (median 85 vs. 70; p = 0.001) and HRQoL impairment (median score 5 vs. 7; p = 0.001) than the CL group. Symptomatic lymphedema (LELQ > 5) was significantly lower in the SLN group (7.0 %) than in the CL group (34.4 %, p = 0.002). No significant differences in intra- or postoperative complications were observed.

Conclusion

SLN biopsy was associated with improved QoL and lower incidence of lymphedema compared to complete lymphadenectomy. These findings support the use of SLN mapping as the preferred nodal staging technique to minimize morbidity and enhance survivorship outcomes in early-stage EC patients.

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淋巴结分期技术对早期子宫内膜癌淋巴水肿和生活质量的影响：一项前瞻性队列研究

前哨淋巴结（SLN）活检越来越多地取代完全盆腔淋巴结切除术（CL）来分期早期子宫内膜癌（EC），但其对患者生活质量（QoL）和淋巴水肿的长期影响尚不清楚。目的比较SLN和CL分期患者的总体健康感知（oHP）、健康相关生活质量（HRQoL）和症状性淋巴水肿。次要目的包括评估症状性淋巴水肿和手术并发症。方法：我们进行了一项前瞻性单中心观察性研究，包括97例早期EC患者，其中50例接受SLN + CL， 47例仅接受SLN。患者在基线和6个月随访时完成EQ-5D-3L、oHP量表（0-100）和自报下肢淋巴水肿问卷（LELQ）。多变量分析调整了混杂因素，包括手术入路和辅助治疗。结果6个月后，SLN组oHP明显改善(中位数85 vs 70；p = 0.001)和HRQoL损害(中位评分5 vs. 7；p = 0.001)。症状性淋巴水肿(LELQ >；5) SLN组（7.0%）明显低于CL组（34.4%,p = 0.002）。两组术后并发症发生率无显著差异。结论与完全淋巴结切除术相比，sln活检与改善生活质量和降低淋巴水肿发生率相关。这些发现支持使用SLN定位作为首选的淋巴结分期技术，以减少早期EC患者的发病率和提高生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.